Questions posted in the Neurology and Neurosurgery Forum have been answered by doctors from The Cleveland Clinic Foundation.

Subject: Re: Possible Arachnoiditis
Forum: The Neurology and Neurosurgery Forum
Topic Area: Arachnoiditis
Posted by CCF Neurology MD - AY on September 25, 1998 at 06:51:24:
In Reply to: Possible Arachnoiditis posted by Richard on September 24, 1998 at 23:10:02:



Symptoms of Arachnoiditis.

Complicated medical history and treatment. Sorry

Im a late 30 year old male that suffered a bulging disc at L4-5 in early 91.
Standard physical therapy, epidrals, and analgesic treatments for 1 year prior to surgery.
No help.
Lamanectomy in early 92 and discovered durring surgery L3-4 bulged. Disectomy on both
levels.
Successful recovery in 7 weeks and return to work.

With in 3 months left leg symptoms developed. Pins, needles, burning, walking on glass,
shooting pain to great toe radiating from inner thigh and deep stabing pain at L4-5 in lower back. All symptoms occur with minor
activity sitting, standing, walking, ridding. Pain is debilitating yet I have remained in good
physical condition through lite exercise and stretching. Better than an 20 year old.
Post surgical myloghram in late 92 revealed scare tissue at nerve root at L5. None
surgical. Enhanced M.R.I.. confirms such. Referred for pain management.
Have received multiple epidurals, Rax, and spinal stimulator up to this time period. No or
little effect. E.M.G. normal. Multiple second opinions that range from degenerative disc
disease to its all in my head.
Over the last 8-12 months new symptoms have appeared to complicate a diagnosis. Right
upper thigh numbness, irritable bowl syndrome and bladder incontinence. Recent M.R.I. was unremarkable. Good disc space.

My question is: do these symptoms reflect this disorder or something else. My Dr's are stumped.

Thank you



Thanks for your question. The symptoms described in your message are
highly suggestive of root irritation in the lumbo-sacral region, and a
persistent inflammatory process of the arachnoids (arachnoiditis) can
definitely be causing such symptoms. A number of relatively routine
tests would further clarify your situation: has your physician considered
a spinal tap? I realize that your surgical incision is directly over
the site (L4-L5 disc space) most commonly used for a Lumbar Puncture, but
there are other locations where the Cerebro-spinal fluid (CSF) can be collected.
The CSF should demonstrate signs of chronic inflammation if you have
arachnoiditis. You mentioned that an EMG was performed and was normal -
when was the EMG done? If it was done more than 6 months ago, you might
consider a repeat exam, particularly if the character of the pain has
changed, and/or you are developing weakness in your lower extremities.

I hope this information is helpful. Best of luck.

This information is provided for general medical education purposes only.
Please consult your doctor regarding diagnostic and treatment options.

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