In Reply:—

We wish to thank Drs. Errando and Peiró for their remarks. The position of the patient on the operating table was supine, the device used to secure the limbs by our surgeon was a lateral external holding device situated in the upper third of the limb. There was no bumper on the perineal region.

Although we agree that the positioning of the patient can account for some neurologic injuries, it seems quite difficult to explain how, in a case like this one, an external compression device (perineal bumper) could harm the perineal nerves with sphynctereal control that lies in the deep structures of the perineum, without inducing any sensory losses in the perineal region. 1We might also add that other etiologies, such as hysterical conversions, are also possible, although of a lower probability. 2 


Raj PP, Pai U, Rawal N: Techniques of regional anesthesia in adults, Clinical Practice of Regional Anesthesia, 1stedition. Edited by Raj PP. New York, Churchill Livingstone, 1991, pp 271–365
Laraki M, Orliaguet GA, Flandin C, Merckx Jand Barrier G: Hysterical paraplegia as a cause of transient paraplegia after epidural anesthesia. Anesthesia Analgesia 1996; 83: 876–7