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Acute bilateral foot drop with or without cauda equina syndrome—a case series
INTRODUCTION: Isolated acute bilateral foot drop due to degenerative spine disease is an extremely rare neurosurgical presentation, whilst the literature is rich with accounts of chronic bilateral foot drop occurring as a sequela of systemic illnesses. We present, to our knowledge, the largest case...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Vienna
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7966217/ https://www.ncbi.nlm.nih.gov/pubmed/33550516 http://dx.doi.org/10.1007/s00701-021-04735-0 |
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author | Demetriades, Andreas K. Mancuso-Marcello, Marco Baig Mirza, Asfand Frantzias, Joseph Bell, David A. Selway, Richard Gullan, Richard |
author_facet | Demetriades, Andreas K. Mancuso-Marcello, Marco Baig Mirza, Asfand Frantzias, Joseph Bell, David A. Selway, Richard Gullan, Richard |
author_sort | Demetriades, Andreas K. |
collection | PubMed |
description | INTRODUCTION: Isolated acute bilateral foot drop due to degenerative spine disease is an extremely rare neurosurgical presentation, whilst the literature is rich with accounts of chronic bilateral foot drop occurring as a sequela of systemic illnesses. We present, to our knowledge, the largest case series of acute bilateral foot drop, with trauma and relevant systemic illness excluded. METHODS: Data from three different centres had been collected at the time of historic treatment, and records were subsequently reviewed retrospectively, documenting the clinical presentation, radiological level of compression, timing of surgery, and degree of neurological recovery. RESULTS: Seven patients are presented. The mean age at presentation was 52.1 years (range 41–66). All patients but one were male. All had a painful radiculopathic presentation. Relevant discopathy was observed from L2/3 to L5/S1, the commonest level being L3/4. Five were treated within 24 h of presentation, and two within 48 h. Three had concomitant cauda equina syndrome; of these, the first two made a full motor recovery, one by 6 weeks follow-up and the second on the same-day post-op evaluation. Overall, five out of seven cases had full resolution of their ankle dorsiflexion pareses. One patient with 1/5 power has not improved. Another with 1/5 weakness improved to normal on the one side and to 3/5 on the other. CONCLUSION: When bilateral foot drop occurs acutely, we encourage the consideration of degenerative spinal disease. Relevant discopathy was observed from L2/3 to L5/S1; aberrant innervation may be at play. Cauda equina syndrome is not necessarily associated with acute bilateral foot drop. The prognosis seems to be pretty good with respect to recovery of the foot drop, especially if partial at presentation and if treated within 48 h. |
format | Online Article Text |
id | pubmed-7966217 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Springer Vienna |
record_format | MEDLINE/PubMed |
spelling | pubmed-79662172021-04-01 Acute bilateral foot drop with or without cauda equina syndrome—a case series Demetriades, Andreas K. Mancuso-Marcello, Marco Baig Mirza, Asfand Frantzias, Joseph Bell, David A. Selway, Richard Gullan, Richard Acta Neurochir (Wien) Original Article - Spine degenerative INTRODUCTION: Isolated acute bilateral foot drop due to degenerative spine disease is an extremely rare neurosurgical presentation, whilst the literature is rich with accounts of chronic bilateral foot drop occurring as a sequela of systemic illnesses. We present, to our knowledge, the largest case series of acute bilateral foot drop, with trauma and relevant systemic illness excluded. METHODS: Data from three different centres had been collected at the time of historic treatment, and records were subsequently reviewed retrospectively, documenting the clinical presentation, radiological level of compression, timing of surgery, and degree of neurological recovery. RESULTS: Seven patients are presented. The mean age at presentation was 52.1 years (range 41–66). All patients but one were male. All had a painful radiculopathic presentation. Relevant discopathy was observed from L2/3 to L5/S1, the commonest level being L3/4. Five were treated within 24 h of presentation, and two within 48 h. Three had concomitant cauda equina syndrome; of these, the first two made a full motor recovery, one by 6 weeks follow-up and the second on the same-day post-op evaluation. Overall, five out of seven cases had full resolution of their ankle dorsiflexion pareses. One patient with 1/5 power has not improved. Another with 1/5 weakness improved to normal on the one side and to 3/5 on the other. CONCLUSION: When bilateral foot drop occurs acutely, we encourage the consideration of degenerative spinal disease. Relevant discopathy was observed from L2/3 to L5/S1; aberrant innervation may be at play. Cauda equina syndrome is not necessarily associated with acute bilateral foot drop. The prognosis seems to be pretty good with respect to recovery of the foot drop, especially if partial at presentation and if treated within 48 h. Springer Vienna 2021-02-07 2021 /pmc/articles/PMC7966217/ /pubmed/33550516 http://dx.doi.org/10.1007/s00701-021-04735-0 Text en © The Author(s) 2021 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Original Article - Spine degenerative Demetriades, Andreas K. Mancuso-Marcello, Marco Baig Mirza, Asfand Frantzias, Joseph Bell, David A. Selway, Richard Gullan, Richard Acute bilateral foot drop with or without cauda equina syndrome—a case series |
title | Acute bilateral foot drop with or without cauda equina syndrome—a case series |
title_full | Acute bilateral foot drop with or without cauda equina syndrome—a case series |
title_fullStr | Acute bilateral foot drop with or without cauda equina syndrome—a case series |
title_full_unstemmed | Acute bilateral foot drop with or without cauda equina syndrome—a case series |
title_short | Acute bilateral foot drop with or without cauda equina syndrome—a case series |
title_sort | acute bilateral foot drop with or without cauda equina syndrome—a case series |
topic | Original Article - Spine degenerative |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7966217/ https://www.ncbi.nlm.nih.gov/pubmed/33550516 http://dx.doi.org/10.1007/s00701-021-04735-0 |
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