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Conus Medullaris Syndrome as a Complication of Radioisotope Cisternography

Published online by Cambridge University Press:  02 December 2014

Bek-San Park ,
Jinse Park ,
Seong-Ho Koh ,
Hojin Choi ,
Hyun-Jeung Yu ,
Koo-Eun Lee ,
Young Joo Lee  and
Kyu-Yong Lee
Bek-San Park
Affiliation:
Department of Neurology, Hanyang University College of Medicine, Seoul
Jinse Park
Affiliation:
Department of Neurology, Inje University Paik Hospital, Pusan, Korea
Seong-Ho Koh*
Affiliation:
Department of Neurology, Hanyang University College of Medicine, Seoul
Hojin Choi
Affiliation:
Department of Neurology, Hanyang University College of Medicine, Seoul
Hyun-Jeung Yu
Affiliation:
Department of Neurology, Bundang Jesaeng Hospital, Gyeonggi, South Korea
Koo-Eun Lee
Affiliation:
Department of Neurology, Bundang Jesaeng Hospital, Gyeonggi, South Korea
Young Joo Lee
Affiliation:
Department of Neurology, Hanyang University College of Medicine, Seoul
Kyu-Yong Lee
Affiliation:
Department of Neurology, Hanyang University College of Medicine, Seoul
*
Department of Neurology, Hanyang University College of Medicine, Gu-ri Hospital 249-1, Gyomun-dong, Guri-si, Gyeonggi-do, 471-701, Korea. Email: [email protected]
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Abstract

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Objective:

Conus medullaris syndrome (CMS) is a clinical neurologic syndrome caused by a conus medullaris lesion. CMS is a heterogeneous entity with various etiologies such as trauma or a space-occupying lesion. Multiple cases of CMS following spinal anesthesia have been reported, but CMS after radioisotope (RI) cisternography has not yet been reported.

Methods:

We present four patients who developed CMS after RI cisternography.

Results:

All experienced neurological deficits such as paraparesis, sensory loss, and urinary incontinence three to four days after RI cisternography. Two showed abnormalities on lumbar magnetic resonance imaging, and three had complete symptom resolution within ten weeks.

Conclusions:

The pathomechanism of the CMS is unclear, but we hypothesize that RI neurotoxicity might be responsible. It is possible that the use of low-dose 99mTc-DTPA or an alternative diagnostic tool such as magnetic resonance cisternography could help to prevent this complication.

Type
Research Article
Information
Canadian Journal of Neurological Sciences , Volume 39 , Issue 3 , May 2012 , pp. 347 - 351
Copyright
Copyright © The Canadian Journal of Neurological 2012

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