I was on call the other night and get called to L and D to see a lady with severe back pain and increasing unilateral leg weakness. Lady is a 30 something year old, second baby, who had an epidural for delivey which was d/c'ed about 24 hours prior. Epidural had worked well and had resolved totally per the patient. She said she had some back pain at the epidural site but over the past few hours this had intensified and that her left leg was numb and weak. On exam she was tearful, epidural site with some bruising and she was very tender not only at the site but above and below the site. Left leg had both extensor and flexor weakness but exam seemed limited by effort because of pain. She also had a sensory deficit to cold over the anterior and medial aspect of her thigh and to her whole foot. I looked back at her chart and it had been a moderately difficult epidural with two attempts, the first with a right sided paresthesia and frank blood in the catheter. Normal labs. Only pushed for about 10 minutes, no birth canal instrumentation. I sent her for a stat lumbar MRI which was totally normal, no hematoma, no disc abnormalities. Now what?