Post-lumbar puncture arachnoiditis. The need for directed questioning.
The inflammation of the arachnoid mater may produce a fibrinous exudate around the roots that causes them to adhere to the dural sheath. We report the case of a man aged 23 years who suffered from acute inflammatory truncated sciatica. The diagnosis of adhesive arachnoiditis was made in front of clinical arguments associated to typical signs on Myelo CT Scan and MRI. The only explanation ever found was a traumatic lumbar puncture at the age of 6 years for suspected meningitis. Sequelae of arachnoiditis are difficult to diagnosis. When MRI or myelography suggests it as a possibility, precise directed questioning is necessary to seek a history, albeit distant, of spinal or meningeal events.
Etchepare
Fabien
F
Department of Rheumatology, Hospital Pitié-Salpêtrière, 47-83 boulevard de l'Hôpital, 75013 Paris, France. f.etchepare@psl.ap-hop-paris.fr
Roche
Bruno
B
Rozenberg
Sylvie
S
Dion
Elisabeth
E
Bourgeois
Pierre
P
Fautrel
Bruno
B
D000328:Adult; D001100:Arachnoiditis / Q000175:diagnosis / Q000209:etiology*; D002908:Chronic Disease; D006801:Humans; D017116:Low Back Pain / Q000209:etiology; D008279:Magnetic Resonance Imaging; D008297:Male; D009192:Myelography; D012585:Sciatica / Q000209:etiology; D013129:Spinal Puncture / Q000009:adverse effects*; D013997:Time Factors; D014057:Tomography, X-Ray Computed