An Intrathecal Pump Misadventure in Two Acts: An Unrecognized Partial Pocket Fill Followed by an Unusual Withdrawal Syndrome Two Months Later.

We present a case of a patient with an intrathecal pump who experienced an unrecognized partial pocket fill, leading to an atypical opioid withdrawal characterized by akathisia. A 57-year-old female with multiple myeloma presented to an emergency department with new-onset akathisia requiring admission. Eight weeks prior, her intrathecal pump was refilled with morphine, bupivacaine, and ziconotide.