Foix–Alajouanine_syndrome

Foix–Alajouanine syndrome

Foix–Alajouanine syndrome

Medical condition

Foix–Alajouanine syndrome, also called subacute ascending necrotizing myelitis,[1] is a disease caused by an arteriovenous malformation of the spinal cord.[2] In particular, most cases involve dural arteriovenous malformations that present in the lower thoracic or lumbar spinal cord. The condition is named after Charles Foix and Théophile Alajouanine who first described the condition in 1926.[3][4]

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Signs and symptoms

The patients can present with symptoms indicating spinal cord involvement such as (paralysis of arms and legs, numbness and loss of sensation and sphincter dysfunction), and pathological examination reveals disseminated nerve cell death in the spinal cord.

Diagnosis

Clinically, the patient may present with neurological symptoms such as numbness, weakness, loss of reflexes, or even sudden or progressive paralysis.[5] The affected portion of the body will correlate to where the lesion lies within the spinal cord. The disease typically has an insidious onset, but symptoms may manifest suddenly. A thorough physical exam may lead a physician toward targeted imaging, with MRI being the most appropriate imaging modality for initial diagnosis. A spinal MRA will serve as a superior imaging technique to visualize the extent of the arteriovenous malformation within the cord and may be especially useful if surgical treatment is attempted.[6]

Treatment

Surgical treatment may be attempted with endovascular embolization or ligation of the arteriovenous malformation within the spinal cord.Corticosteroids may be used acutely to help slow the progression of symptoms or they may be used chronically in a poor surgical candidate.[7] In either case, physical therapy will be an important part of the recovery process in helping the patient regain strength and coordination.

See also

References

  1. [1]
    "Foix-Alajouanine syndrome". Orphanet.
  2. [2]
    Mishra R, Kaw R (May 2005). "Foix–Alajouanine syndrome: an uncommon cause of myelopathy from an anatomic variant circulation". South. Med. J. 98 (5): 567–9. doi:10.1097/01.SMJ.0000154409.48800.43. PMID 15954517. S2CID 41113400.
  3. [3]
    Krishnan, Prasad; Banerjee, TapasKumar; Saha, Manash (2013). "Congestive myelopathy (Foix-Alajouanine Syndrome) due to intradural arteriovenous fistula of the filum terminale fed by anterior spinal artery: Case report and review of literature". Annals of Indian Academy of Neurology. 16 (3): 432–436. doi:10.4103/0972-2327.116931. PMC 3788302. PMID 24101838.
  4. [4]
    "Foix-Alajouanine disease". www.whonamedit.com. Retrieved 2022-04-12.
  5. [5]
    Palmer, Cheryl Ann. "Foix-Alajouanine Syndrome". Medscape.
  6. [6]
    Koenigsberg, Robert (12 July 2022). "Arteriovenous Malformation Brain Imaging". Medscape.
  7. [7]
    D’haeseleer, Miguel (1 June 2014). "Systemic use of corticosteroids in neurological disorders". Journal of Translational Internal Medicine. 2 (2): 70–72. doi:10.4103/2224-4018.135603.
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