What are the clinical features of spinal cord compression from
epidural metastasis ?
The initial symptom is progressive axial pain, referred or radicular, which may last for days to months. Recumbency frequently aggravates the pain, unlike the pain of degenerative joint disease where it is relieved. Weakness, sensory loss and incon-tinence typically develop after the pain. Once a neurological deficit appears, it can evolve rapidly to paraplegia over a period of hours to days. In suspected cases MR! of the spine must be done by the next day. About 50% of cases in adults arise from breast, lung or prostate cancer. Compression usually occurs in the setting of dis-seminated disease. It is at the thoracic level in 70% of cases, lumbar in 20% and cervical in 10%, and occurs at multiple, non-contiguous levels in less than half of the cases. The tumour usually occupies the anterior or anterolateral spinal canal. CSF findings are non-specific in metastatic epidural compression. The cell count is usually normal, bu! protein levels may be raised because the flow of CSF is impeded. Lumbar puncture has been known to worsen the neurological deficit, presumably due to impaction of the cord.
Lexo edhe:
The initial symptom is progressive axial pain, referred or radicular, which may last for days to months. Recumbency frequently aggravates the pain, unlike the pain of degenerative joint disease where it is relieved. Weakness, sensory loss and incon-tinence typically develop after the pain. Once a neurological deficit appears, it can evolve rapidly to paraplegia over a period of hours to days. In suspected cases MR! of the spine must be done by the next day. About 50% of cases in adults arise from breast, lung or prostate cancer. Compression usually occurs in the setting of dis-seminated disease. It is at the thoracic level in 70% of cases, lumbar in 20% and cervical in 10%, and occurs at multiple, non-contiguous levels in less than half of the cases. The tumour usually occupies the anterior or anterolateral spinal canal. CSF findings are non-specific in metastatic epidural compression. The cell count is usually normal, bu! protein levels may be raised because the flow of CSF is impeded. Lumbar puncture has been known to worsen the neurological deficit, presumably due to impaction of the cord.
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Lexo edhe:
