General Discussion Arachnoiditis is a disease characterized by an acute inflammatory stage that occurs in the dura (exterior) and the arachnoid (interior), two of the three membranes that cover and protect the brain, the spinal cord and the nerve roots. The arachnoid contains the cerebrospinal fluid which circulates from the brain to the sacral area, about every two hours; it filters any invasion and usually responds first by inflammation and follows with a chronic stage life-lasting phase characterized by scarring and fibrosis. Php Serial Extension Free more. As a result, abnormal adhesion of nerve roots to the dural sac or to each other (clumping) occurs in a variety of configurations that alter significantly the function of the roots and the spinal cord. This causes a variety of neurological deficits and severe chronic neuropathic pain usually located in the area affected.
Highlights the full text of a fact sheet entitled 'Arachnoiditis,' provided by the National Institute of Neurological Disorders and Stroke (NINDS) of the National Institutes of Health in Bethesda, Maryland.
In the pre-antibiotic era, severe cases of tuberculosis or syphilis invaded the spine causing arachnoiditis; currently these infections are rare, but it is important to mention that arachnoiditis will result in most patients affected by fungal meningitis from attempted epidural injections of tainted steroids. The severity of the symptoms usually depends on the extent and location of the injurious event, direct injury to the spinal cord or to the nerve roots resulting in immediate, severe pain in the corresponding area of innervation (i.e. The area that is supplied by the affected nerves). Dgn Shp Converter on this page. Driver Epson M188d Windows 7. Chronic severe pain is mostly localized in the lower back, perineum, legs and feet; it may appear weeks after a spinal surgical intervention or an injection into the neuroaxis that went astray. In most cases the pain is intense, accompanied by tingling or burning on the legs and feet; skin sensations like “bugs crawling” or “water dripping”. Frequently patients complain of severe pain radiating to the lower extremities, muscle cramps, gait abnormalities and alterations of proprioception. Software Resetter Printer Epson Stylus Photo R230x.
Moreover, patients suffer from severe headaches, vision disturbances, hearing problems, dizziness and nausea. Bowel, bladder and sexual dysfunction as well as “electric shocks” type of pain are common in patients with severe arachnoiditis. All the symptoms are caused by the alteration and impediment of the CSF circulation resulting from clumped nerve roots, scar tissue and fibrosis. Severe complications from multiple operative procedures in the spine may ensue in spinal cord damage, like “softening” (myelomalacia) or elongation of the nerve roots as in cases when the nerve roots and/or the spinal cord adhere to the dural sac wall. Some patients may develop arachnoid cysts and or syringomyelia.
(For more information on these conditions, choose “arachnoid cysts” or “syringomyelia” as your search term in the Rare Disease Database.) Most symptoms are initially due to progressive inflammation around where damage to the arachnoid membrane was produced. Because in the early stages, arachnoiditis is usually a progressive disorder, first it is characterized by inflammation of the arachnoid membrane and invasion of the subarachnoid space.
Eventually, the nerve roots undergo an inflammatory stage in the affected areas and after three months, they begin to adhere to each other and to the inner layer of the arachnoid initiating the adhesive phase of arachnoiditis. Subsequently, these adhesions can exert undue pressure upon the nerve roots or the dural sac wall and eventually result in scarring and fibrosis which in turn may restrict blood flow to the affected area and eventually also impede the free flow of the CSF. In this manner of distribution, the rotation of the CSF can spread infections, disseminate malignant tumors, and disperse fungi. There are numerous causes of arachnoiditis: a)Direct mechanical injuries (dural cut/tear) caused by surgical interventions, especially repeat spinal operations, after fusions or minimally invasive procedures requiring corrective surgeries.