Elsberg syndrome

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The Elsberg syndrome is (controversial as a separate entity) a neurological disease picture and refers to inflammation of the lower spinal cord and nerve roots, a Radikulomyelitis of Conus medullaris and cauda equina . The proper name goes back to the New York neurosurgeon Charles Elsberg .

Complaint picture

The clinical picture of Elsberg syndrome corresponds to a so-called cone- cauda equina syndrome : In addition to flaccid leg paralysis ( paraparesis ), bladder emptying and sexual dysfunction as well as rectal disorders typically occur. Sensory disorders can occur and are located in lumbar and sacral dermatomes . Symptoms usually come on quickly. Signs of the pyramidal tract are atypical, as there is myelitis of the most caudal sections of the spinal cord.

etiology

The triggers for Elsberg syndrome are not uniform. Similar to Miller-Fisher syndrome , it can occur as a variant of Guillain-Barré syndrome . A connection with numerous viral infections has also been described, above all infections with herpes simplex type 2 in addition to cytomegalovirus (CMV), Epstein-Barr virus (EBV) or HIV . Another cause can be neuroborreliosis . Other publications describe the occurrence of Elsberg syndrome after circulatory disorders, vascular inflammation or worm infections.

Diagnosis

There is an increase in the number of cells in the cerebrospinal fluid ( liquor cerebrospinalis ), usually in the form of lymphocytic pleocytosis. The magnetic resonance imaging may have inflammation in the lower end of the spinal cord or cauda equina. Both examinations should be carried out to rule out other diagnoses: The most common cause of an isolated cone-cauda equina syndrome is herniated discs, other causes can be spinal tumors or encephalomyelitis disseminata (multiple sclerosis).

therapy and progress

Therapy consists of treating the underlying disease; otherwise, in addition to symptomatic therapy, corticosteroids can be considered. In the original description, the symptoms are chronically progressive, but usually regressive.

swell

  • CA Elsberg: Experiences in spinal surgery. Observation upon 60 laminectomies for spinal disease. In: Surg. Gynecol Obstet. 16, 1931, pp. 117-135.
  • A. Hufschmidt, CH Lücking, S. Rauer: Neurology compact. 5th edition. Thieme Verlag, 2009, ISBN 978-3-13-117195-5 .
  • K. Masuhr, M. Neumann: Neurology. 6th edition. Thieme Verlag, 2007, ISBN 978-3-13-135946-9 .
  • D. Wildgruber et al .: Elsberg syndrome due to infarction of the conus medullaris associated with a prothrombin mutation. In: Journal of Neurology. 246 (6), 1999, pp. 507-508.
  • C. Börnke et al.: Lumbosacral radiculitis (Elsberg's syndrome) with isolated angiitis of the central nervous system. In: Journal of Neurology. 243 (9), 1996, pp. 662-664.
  • M. Furugen et al: Elsberg syndrome with eosinophilic meningoencephalitis caused by Angiostrongylus cantonensis. In: Internal Medicine. (Tokyo, Japan). 45 (22), 2006, pp. 1333-1336.