Letters However, Hardy reported acute hypo-

acousis in three patients at the end of injec-tion of local anaesthetic solution in the lumbar extradural space and postulated that the hypoacousis in his cases was a con-sequence of the increase in perilymph pres-sure which accompanied the increase in cerebrospinal fluid pressure.6 We report an unusual case of reversible bilateral abducens nerve, right facial nerve and bilateral vestibulocochlear nerve palsies following epidural anaesthesia. A 65 year old woman who had been having regular haemodialysis for chronic renal failure for many years was referred for management of intractable and increasingly severe pain i