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Epidural lipomatosis hypothyroidism – Cauda Equina Syndrome Caused by Idiopathic Epidural Lipomatosis

The corticosteroid from the ESI provides the substrate for the formation of cortisol.

William Murphy
Thursday, July 28, 2016
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  • Idiopathic thoracic epidural lipomatosis with chest pain. The patient realized a good postoperative outcome and experienced an immediate considerable symptom improvement.

  • Nouv Press Med 8: —, Most epidural lipomatosis hypothyroidism of EL are associated with long-term use of exogenous steroids, but a number of cases have been reported, which are associated with Cushing's disease, hypothyroidism, and pituitary prolactinoma [ 4 ].

  • CK is defined as a kyphosis of the spine caused by abnormal vertebral somatogenesis, including failure of either segmentation or formation of vertebrae, or a combination of both [ 10 ]. Correction of underlying endocrine abnormality can reverse the process.

Case presentation

J Neurosurg —, Guegan YFardoun RLaunois Bet al : Spinal cord compression hypothyroidism extradural fat after prolonged corticosteroid therapy. However, it is stated that the increased hypothytoidism of epidural fat may lead to a better performance of physical activities such as stairs climbing in the older population. Baron RB Nutritional disorder. This included 70 patients with EL and 34 without EL. These included weight reduction of an overweight patient with minimal neurological findings in one case and decompressive laminectomy and fat debulking to achieve adequate cord decompression in the remaining three cases.

N Engl J Med — Fain JN Catecholamine-thyroid hormone interactions epidural lipomatosis hypothyroidism liver and adipose tissue. Apart from these comparatively severe anomalies, which may cause major neurological deficits, several smaller and easily ignored anomalies exist [ 56 ], such as diminished spinal cord, narrowed spinal canal, and spinal epidural lipomatosis SEL. Surgical intervention is indicated in case of severe or progressive neurologic deficits.

I agree, dismiss this banner. This article may contains scientific references. J Neuroradiol —25 Google Scholar Can Med Assoc J. There are some other medical disorders such as; neoplasm, hemorrhage or infectionwhich may pose the same symptomology and mislead the diagnosis of the disease. When endocrinology and spinal surgery meet.

Plain hypothyroixism of the lumbar spine are usually normal, but MRI is the imaging tool of choice. The effect of thyroid status upon oxygen consumption and lipolysis. Article PubMed Google Scholar 6. Epidural lipomatosis is a rare disease entity, and it is a pathologic accumulation of fat in the epidural space. J Neurosurg —

Case Reports in Pediatrics

The measurement reliability was consistent with a previous study. J Neurosurg — We report a rare case of idiopathic SEL causing cauda equina syndrome in a non-obese young patient. The first is the retrospective nature of the study. All patients with these kyphotic deformities who underwent deformity correction surgery at our center during the period from January to December were identified from our database.

What exactly causes Epidural Lipomatosis is not yet known, although Epidural Lipomatosis is associated with the following:. Results EL was centered at L5 and S1 segments. Neurosurgery Searching for other associated neurological abnormalities, the urodynamic assessment was normal and the etiological investigation showed a normal rate of triglycerides 0.

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This results in compression of the spinal cord causing a variety of neurological symptoms including pain, numbness, and tingling. Figure 2 A exemplifies mild EL: enhanced visibility of the L5 roots and mildly indented thecal sac. B Axial image showing measurement discrepancy: anterior epidural fat is 7. Epidural lipomatosis is a rare disease entity, and it is a pathologic accumulation of fat in the epidural space. The grading was done on a visual basis, simplified for use in the clinic as none, minimal, moderate and severe EL.

Scheuermann's kyphosis: surgical management. In the present study, two CK li;omatosis and seven TK patients exhibited incomplete paraplegia, and all of these patients met the diagnostic criteria of SEL. Methods This study was approved by the institutional ethical review board. It is not in favor of a myopathy. J Biol Chem — Google Scholar

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Author information Article notes Copyright and License information Disclaimer. Neurosurgery Google Scholar Download references. J Rheumatol — Google Scholar During the follow-up period, his symptoms were much improved.

Excessive EF in the spinal canal may compress epiduarl spinal cord and cause mild or severe neurological symptoms [ 83031 ]. Clin Endocrinol Metab — With the development of radiographic technology, especially the wide use of MRI, hundreds of SEL cases have been reported, and it is no longer a rare condition. The term 'idiopathic SEL' is applied to describe cases without definitive predisposing factors, and the occurrence of idiopathic SEL in non-obese young patient is exceptional. Article PubMed Google Scholar 7. J Spinal Disord Tech.

Accepted 03 Feb Serum phenytoin level was elevated as to Epkdural, Z. Epidural lipomatosis commonly presents with localized chronic pain, which has often lasted months to several years, followed by progressive or sudden neurologic deficits. Aims and Scope Editorial Board Contact us. Our study added another potential factor, SEL, which was previously ignored.

Background

We report a rare case of idiopathic SEL causing cauda equina syndrome in a non-obese young patient. Spinal kyphosis was assessed by measuring the traditional Cobb angle on standing lateral radiographs as described previously [ 19 ]. Contact us. Klin Wochenschr —55 Google Scholar

Clin Oncol R Coll Radiol — There may also be a correlation between the severity of the clinical presentation and lipomatossi delay. Reg Anesth. Neurological examination showed a reactive patient, standing with support; deep tendon reflexes were decreased, the plantar reflex was indifferent to both feet, tone was normal, and two blue spots of 1 cm were seen on the seat and foot. To generate a subpopulation of internal controls without EL, drawn from the same clinical cohort, a convenience sample based upon serial selection of one case from each dozen seen serially was employed. Abnormal levels of steroids can also be produced within the body itself due to some health condition. Surg Neurol —, false.

Meanwhile, cutting off steroidal therapies for those patients who are administering these for chronic reasons is not a suitable choice as they may pose intolerance to this hypothyroidism. There are very few reports of SEL in association with scoliosis 3. Using the T1 image, enhanced contrast will help the clinician to distinguish the two. Both T-test and WMW test had p-values of 0. EL was first described by Lee and colleagues [ 3 ] in an adolescent who was receiving treatment with exogenous steroids after a kidney transplant. In this case, idiopathic SEL was incidentally found in the patient with back pain and lumbar scoliosis.

  • Combination of lumbar kyphosis, epidural lipomatosis, and perineural cyst as a cause of neurological deficit: a case report. Scheuermann's kyphosis: surgical management.

  • Accepted : 05 August

  • Article PubMed Google Scholar 9. Toshniwal, P.

  • Correspondence to Yong Qiu. According to our observation, however, SEL occurs in other spinal kyphotic deformities as well.

Idiopathic thoracic epidural lipomatosis with chest pain. Measurement of spinal curvatures. Sagittal and axial T2 weighted images of the magnetic resonance image show a posterior epidural mass with compressing the cauda equina extending from L2 to S1 segment with high signal intensity. Comput Med Imaging Graph. J Clin Neurosci.

Research and Publication Ethics. Spinal epidural lipomatosis: report of lipomatodis case secondary to hypothyroidism and review of literature. Seex, and G. However, although Epidural lipomatosis hypothyroidism is a secondary change in spinal kyphotic deformities, it may in turn have an effect on spinal kyphosis. Klin Wochenschr —55 Google Scholar Biochemistry — Google Scholar Abstract Spinal epidural lipomatosis SEL is a rare condition that presents as a back pain with progressive neurologic symptoms.

INTRODUCTION

J Neurol : —Toshniwal PK, Glick RP: Spinal epidural lipomatosis: report of a case secondary to hypothyroidism and review of literature. Home Back Pain Fact Checked. Radiogr Today —28 Google Scholar

The effect of thyroid status upon oxygen consumption lipomatosiw lipolysis. Spinal stenosis caused by epidural lipomatosis in Cushings-Syndrome. Methods This study was approved by the institutional ethical review board. Please review our privacy policy. Borre et al. The patient realized a good postoperative outcome and experienced an immediate considerable symptom improvement.

In the control group, the diameters of the EF and DS were measured at the corresponding levels. Endocrinology — Google Scholar Case report. Seex, and G.

Publication types

Search all BMC articles Search. Case Rep Pediatr. This suggests that the location of the lesion should be considered when planning treatment. The probability of developing EL is linear with increasing BMI until a value of 35, at which point the probability curve begins to plateau Figure 6 A.

J Clin Invest. Alberto Munoz James A. The ratio of cross sectional area of epidural fat to that of the dural sac was used as a guide. Neurosurgery Google Scholar Can Med Assoc J.

LZ and ZZZ participated in the study design, data collection, and revision of the manuscript. But epidural lipomatosis hypothyroidism patient had neither hhpothyroidism nor steroid treatment. We report an observation of an month-old child who presented with walking delay without other abnormalities, and the radiological exploration confirmed the lumbar epidural lipomatosis. Lipid metabolism in hypo- and hyperthyroidism. J Neurosurg — Clin Endocrinol Metab —

A retrospective analysis. It was noted in the charts of ten patients in the EL group who self-reported stress and eight who self-reported alcohol consumption. Next Post. So, cervical involvement is rare. SEL is often an incidental finding and the majority of patients remain asymptomatic 1.

Associated Data

As stated, Epidural Lipomatosis can hupothyroidism treated both conservatively as well as surgically. Anesthesia and Pain Medicine. A case report. Computed tomography CT and magnetic resonance imaging MRI is the most recommended techniques for the diagnosis of epidural lipomatosis. Weight loss strategy is recommended for only those patients who pose obesity as the underlying cause of their disease.

  • Symptomatic spinal epidural lipomatosis associated with Cushing's syndrome. Most affected patients are obese and receiving steroid therapy, or have an endocrinopathies.

  • Eighteen of these 52 patients from the remainingcontingent on the availability of a complete record, were found to have mild EL. J Surg Case Rep308 Mar

  • J Biol Chem — Google Scholar It has been epidural lipomatosis hypothyroidism established that the main etiological factors of SEL are related to endocrine dysfunctions, such as those associated with Cushing's disease, hypothyroidism, obesity, iatrogenic steroid treatment of immune disorders, COPD, and transplantation 45.

  • It was noted in the charts of ten patients in the EL diet weight who self-reported stress and eight who self-reported alcohol consumption. The prolonged administration of the steroidal therapies for various medical pathologies may lead to the formation of epidural lipomatosis.

Received : 15 October SEL was first reported by Lee et al. Find articles by Yun Seong Kim. Revised 05 Jan Spinal epidural lipomatosis: report of a case secondary to hypothyroidism and review of literature. Journal of the Korean Neurological Association ;15 3 :

The authors would like to thank Christina Jaimes, M. Click here for subscription options. Gero B, Chynn K Symptomatic spinal epidural lipomatosis without exogenous steroid intake. J Comput Assist Tomogr —, false. Background Epidural lipomatosis EL is an increase of adipose tissue, normally occurring in the epidural space, sufficient to distort the thecal sac and even compress neural elements.

The BMI was Accepted 03 Feb Epidural lipomatosis EL is a rare condition characterized by the accumulation of unencapsulated fat within the epidural space. But in our patient, regretfully STIR sequence was not performed.

What Causes Epidural Lipomatosis?

Rachis — Google Scholar The chief complaints, causes, and associated complaints were determined hypothyroidism history and physical examination as specified in Table 1. With diligent followups and close screenings an individual post treatment can be successfully treated from Epidural Lipomatosis. Peeters F, Koster P Epidural lipomatosis simulating spinal canal stenosis or herniated nucleous pulposus. Received : 08 February

Also, an increase in adipose tissue cortisol hypothyroidism lead to lipolysis with increased triglycerides [ 26 ]. The patient had no history of steroid use, epidural steroid injections, no medical co-morbidities and taking no regular medication. Spontaneous resolution of spinal epidural lipomatosis. The patients with symptomatic EL may have radiculopathy, myelopathy, claudication, cauda equina syndrome, or paraplegia. Figure 7. Radiology —

The average BMI for men was N Engl J Med However, before going for this epidural lipomatosis hypothyroidism it is important to determine the cause of the steroid use, meaning the underlying condition for which the steroid was given in the first place. Leave a Reply cancel reply. Conclusion The development of EL is multi-factorial, the risk factors being intertwined and additive.

Epidural lipomatosis Symptoms, Causes, Disability, Surgery, Alternative Treatment

Lee M. Our articles are resourced from reputable online pages. Figure 1 Lumbar spine A and whole spine B anterior-posterior X-rays show lumbar spine scoliosis Lenke classification; 5BN without any significant vertebral abnormality. Both authors read and approved the final manuscript.

So, cervical involvement is rare. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Public Health. Please review our privacy policy. N Engl J Med —, Godersky M.

Idiopathic SEL causing neurological deficits occurs more frequently in the thoracic than in the lumbar spine. Most affected patients are obese and receiving steroid therapy, or have an endocrinopathies. J Neurosurg — Google Scholar But in our case, the walking delay is the only inaugural symptom without peripheral neurological cause or myopathy, and no urodynamic disorders were observed.

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Combination of lumbar kyphosis, epidural lipomatosis, and perineural cyst as a cause of neurological deficit: a case report. Moreover, short T1 inversion recovery STIR sequence may be useful for confirmation of diagnosis as lipid is hypointense in this sequence. Biochemistry —

Idiopathic and glucocorticoid-induced spinal epidural lipomatosis. According to our observation, however, SEL occurs in other spinal kyphotic deformities as well. J Spine Surg. Hypothydoidism study, however, demonstrated that SEL should be a secondary rather than a primary change in spinal kyphotic deformities, as it occurred in both congenital and acquired spinal kyphotic deformities. Published : 16 March Sabharwal S, Mahmood F. The finding that thoracic hypokyphosis is an important characteristic of AIS and may play a part in the pathogenesis of scoliosis [ 272829 ] indirectly supports our results.

As stated, individuals with Epidural Lipomatosis have excessive fatty deposition in hypotyhroidism epidural space which is the outermost layer of the spine resulting in compression of the spinal cord. T1 sagittal image confusable with arachnoiditis. Figure 2 Mid-sagittal A and para-sagittal B T1-weighted MR images reveal high-intensity adipose tissue mass in the spinal canal and circumferential epidural fat deposit from L1 lower level to S2. Measurements in the sagittal plane were more consistently replicable than in the axial plane. Spine — Google Scholar 2. J Neurol —, false. Results EL was centered at L5 and S1 segments.

Background

Support Center Support Center. Lumbosacral epidural lipomatosis: MRI grading. Plain radiographs of the lumbar spine showed no abnormalities. Acta Neurochir.

Abstract Spinal epidural lipomatosis Epiduraal is a rare condition that presents epidural lipomatosis hypothyroidism a back pain with progressive neurologic symptoms. Radiol Clin North Am — Immediate online access to all issues from On cross sectional MRI, the thecal sac has a striking stellate appearance with three rays emanating from a central core. The datasets used and analyzed during the current study are available from the first author on reasonable request.

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CT scan is generally performed before the MRI and it is expected to differentiate and explain the causes of compression as well, based on the density of the deposited masses. Tags: Epidural lipomatosis. AGR conceived the study and drafted the original manuscript. Those with EL had an average age of Figure 2 A exemplifies mild EL: enhanced visibility of the L5 roots and mildly indented thecal sac. Probabilities of developing EL computed by logistic regression. Aust NZ J Surg —

Neuroradiology hypotyroidism Google Scholar 9. The patient was successfully managed with conservative treatment. The patient had no history of steroid use, epidural steroid injections, no medical co-morbidities and taking no regular medication. Figure 2 Mid-sagittal A and para-sagittal B T1-weighted MR images reveal high-intensity adipose tissue mass in the spinal canal and circumferential epidural fat deposit from L1 lower level to S2.

J Neurosurg — Google Scholar References 1. Research and Publication Ethics.

  • J Comput Assist Tomogr —

  • Neurological examination showed a reactive patient, standing with support; deep tendon reflexes were decreased, the plantar reflex was indifferent to both feet, tone was normal, and two blue spots of 1 cm were seen on the seat and foot.

  • J Neurol—

  • Rachis — Google Scholar Case Report 3.

External link. J Spinal Disord. Epidural hypothyroidism. Toshniwal View author publications. We report a rare case of idiopathic SEL causing cauda equina syndrome in a non-obese young patient. In that study, the authors included 29 SK patients and 58 controls.

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Thus, the caveat: mild or moderate alcohol consumption may be protective, but only in persons vegetable soup diet weight loss results are not obese. Corresponding author. Previous Post. Pediatric Nephrology. Badami J, Hinck V Symptomatic deposition of epidural fat in a morbidly obese woman. Am J Neuroradiol — Am J Neuroradiol — Google Scholar

The ratio of cross sectional area of epidural fat to that of the dural sac was used as a guide. This article does not provide medical advice. Delete Cancel Save. It is not in favor of a myopathy. A body mass index BMI of the patient was So, in our observation, the initial treatment was conservative because we are not sure that EL would cause walking delay and may be just incidental finding, and no surgical management is decided considering its stationary evolution and its normal urodynamic assessment.

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Reprints and Permissions. CT scan is epidural lipomatosis hypothyroidism performed before the MRI and it is expected to differentiate and explain the causes of compression as well, based on the density of the deposited masses. Biometrics — Google Scholar Buy Online Only Now. Download references.

  • The patients with symptomatic EL may have radiculopathy, myelopathy, claudication, cauda equina syndrome, or paraplegia. Find articles by Yun Seong Kim.

  • Correspondence to Daniel G.

  • However, in a minority of cases, the cause of EL is idiopathic [ 5 ].

  • In a obese patient with radicular pain or progressive paralysis, SEL may be the etiologic factor involved.

  • Toshniwal P, Glick R Spinal epidural lipomatosis: report of a case secondary to hypothyroidism and review for the literature.

Most affected patients are obese and receiving steroid therapy, or have an endocrinopathies. Although EL may be asymptomatic, patients often have symptoms related to nerve or spinal cord compression [ 1 ]. In: Litwack G ed Biochemical actions of hormones, vol 7. On admission, she shows mild hypothyroidism on thyroid function test. Cite this article Zhang, Z.

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Full text links Read article epidural lipomatosis hypothyroidism publisher's site DOI : AGR conceived the study and drafted the original manuscript. Neurosurg Rev — Spontaneous resolution of spinal epidural lipomatosis. The data used to support the findings of this study are included within the article. Clin Neurol Neurosurg.

Consent for publication Not applicable. Revised 05 Jan Cauda equina syndrome due to spinal epidural lipomatosis. A year-old woman was hospitalized with inability to walk for 2 months ago. Editorial Board. Ito et al.

These eighteen patients were combined with the original epidural lipomatosis hypothyroidism patients to form patients with EL 70 patients. Baik I, Shin C: Prospective study of alcohol consumption and metabolic syndrome. Kim K. Read article at publisher's site DOI : Full text links Read article at publisher's site DOI :

According to the diagnostic criteria for SEL previously reported by Borre et al. Symptomatic epidural lipomatosis secondary to obesity. Symptomatic spinal epidural lipomatosis induced by a long-term steroid treatment. The need for early diagnosis of this disorder is therefore emphasized. We suggest that preoperative spine MRI findings should be carefully evaluated, and removal of excessive EF should be taken into consideration. Research and Publication Ethics. Nouv Presse Med —

Journal overview. The age of the controls was The epidural lipomatosis hypothyroidism management consisted of motor physiotherapy with regular follow-up in consultation of neurosurgery, with a stationary evolution, and currently, walking is not yet acquired. N Engl J Med.

  • Fain JN Hormonal regulation of lipid mobilization from adipose tissue.

  • J Comput Assist Tomogr —, false.

  • View author publications.

  • There were 43 men and 61 women in the study. Nouv Press Med 8: —,

Save my name, email, epidural lipomatosis hypothyroidism website in this browser for the next time I comment. EL may be the principal cause of sciatica and secondary cause of neurogenic claudication. A written informed consent was obtained from the parents when they were enrolled. J Neurol —, false. ESI was performed in the appropriate interspace using previously described protocol [ 8 ] with a standard mixture of mg depomedrol in 3 mL normal saline, both preservative free.

There may hypothyroidism be a correlation between the severity of the clinical presentation and the delay. Author Index. Epidural lipomatosis is a rare disease in pediatrics. Spinal epidural lipomatosis: a review of its caused and recommendations for treatment.

Epidural lipomatosis is a rare disease in pediatrics. Myelography followed by computerized tomography were instrumental in lipomwtosis diagnosis of the first three patients; the fourth was diagnosed by magnetic resonance imaging. Scoliosis was classified as Lenke type 5BN Figure 1. The average age of the patients was Spinal stenosis due to SEL was the main issue in this patient.

Hypoothyroidism, and W. Spinal epidural lipomatosis: a review of its causes and recommendations for treatment. We report results observation of an month-old child who presented with walking delay without other abnormalities, and the radiological exploration confirmed the lumbar epidural lipomatosis. N Engl J Med. In a obese patient with radicular pain or progressive paralysis, SEL may be the etiologic factor involved. National Center for Biotechnology InformationU. Download citation.

  • Spinal epidural lipomatosis: a review of its causes and recommendations for treatment.

  • The elderly population is most likely to suffer from Epidural Lipomatosis.

  • Journal of the Korean Neurological Association ;15 3 :

  • Haddad M. The severity of EL was graded by visually assessing the degree of compression and distortion of the thecal sac on all T1 images.

  • J Spinal Disord — Frank E Endoscopic suction decompression of idiopathic epidural lipomatosis.

Background Epidural epidural lipomatosis hypothyroidism EL is an increase of adipose tissue, normally occurring in the epidural space, sufficient to distort the thecal sac and even compress hypothyroidim elements. Measurements in the sagittal plane were more consistently replicable than in the axial plane. Both authors read and approved the final manuscript. Clin Neurol Neurosurg — Google Scholar Computed tomography CT and magnetic resonance imaging MRI is the most recommended techniques for the diagnosis of epidural lipomatosis. Results EL was centered at L5 and S1 segments.

AJNR 3: —, false. Epidural Lipomatosis is a condition which can be treated by both conservative and hypotjyroidism approaches depending on the cause of t he condition and the severity of the symptoms. Study of the physiology of cellular liporegulation in rodents sheds some light on the role of Leptin in human metabolism of fat [ 14 ]. Spinal stenosis due to SEL was the main issue in this patient. Spine — Google Scholar Similar Articles To arrive at the top five similar articles we use a word-weighted algorithm to compare words from the Title and Abstract of each citation. Out of 70 EL patients, 46 were classified as mild.

Contributor Notes

Download references. Spinal epidural lipomatosis - a brief review. J Rheumatol. Baik I, Shin C: Prospective study of alcohol consumption and metabolic syndrome. The Spearman chi-square p-value for EL severity vs.

Epidural lipomatosis hypothyroidism neurological status of the patients was also recorded. We report a rare case of cauda equina syndrome caused by SEL in a non-obese healthy young man without any evident traumatic episode. Most Cited Articles. Med J Aust.

The age of the controls was The apex location varied in different patients. Radiology — Mendelis, and W. Epidural lipomatosis is a rare disease entity, and it is a pathologic accumulation of fat in the epidural space. Sowerbutts JG Some uses of presacral oxygen insufflation.

Case report. Epidural lipomatosis is a rare disease in pediatrics. About this article. All images were obtained from the Picture Archiving and Communication System and measured with Surgimap version

  • Revised 05 Jan Full size image.

  • Share this article Share with email Share with twitter Share with linkedin Share with facebook. Neurosurgery 8: —, false.

  • Correspondence to Yong Qiu. We included three common kyphotic deformities in the present study: congenital kyphosis CKSK, and tuberculotic kyphosis TK.

  • Download citation.

  • Table 1 Summary of reported cases of scoliosis associated with spinal epidural lipomatosis Full table. N Engl J Med —, false.

The dorsal aspect of the thoracic spine is epidrual commonly involved, usually in its total epidural lipomatosis hypothyroidism. Meanwhile, 69 age- and sex-matched control subjects were also enrolled. Excessive EF in the spinal canal may compress the spinal cord and cause mild or severe neurological symptoms [ 83031 ]. Review of the literature and report of two additional cases.

PubMed Google Scholar 8. Studies of alcohol abuse on metabolic syndrome are cogent since EL and metabolic syndrome share many components. Notify me of follow-up comments by email. Cite this article Jaimes, R.

Although EL may be asymptomatic, patients often have symptoms related to nerve or spinal cord compression [ 1 ]. Spinal epidural lipomatosis: a review of its causes and recommendations for treatment. The dorsal aspect of the thoracic spine is most commonly involved, usually in its total extent. J Neurosurg — Google Scholar SEL is characterized as an overgrowth of adipose tissue in the epidural space. Author information Article notes Copyright and License information Disclaimer. The objective of this study is to test the hypothesis that SEL or increased EF commonly occurs in patients with different types of kyphotic deformities as a secondary disorder.

Endocrinology — Google Scholar Radiology — E-mail this Article. Med J Aust — Google Scholar

Urgent decompression via posterior laminectomy and excision of excess epidural fat resulted in an immediate symptom improvement. Clemente DC ed Gray's anatomy. Aims and Scope Editorial Board Contact us. Case report. Neurosurg Focus. Journal Archive. Download references.

Lumbar magnetic resonance image revealed extradural fat compressing the cauda equina. The BMI hypothyroidism Nouv Presse Med — In: Neuromuscular manifestations of systemic disease. All images were obtained from the Picture Archiving and Communication System and measured with Surgimap version Sowerbutts JG Some uses of presacral oxygen insufflation. The coexistence of spinal deformity and intraspinal anomalies has been reported in many previous studies [ 1234 ].

Searching for other associated neurological abnormalities, the urodynamic assessment was normal and the etiological investigation showed a normal rate of triglycerides 0. The arrow points to the indentation of the thecal sac. Case report. Cited by: 10 articles PMID:

She had a history of myoclonic seizure and treated with phenytoin mg for 8 years. The management was mainly symptomatic, based on motor physiotherapy with additional management in neurosurgery. This is especially the case after spinal kyphosis correction surgery, as the spinal canal will become narrower due to the contraction of spinal ligaments. Klin Wochenschr —

We searched for etiologies of SEL. Figure 2 D is an image taken at the L4 level and illustrates the case where although the thecal sac and epidural fat are equal, the neural elements are compressed significantly thus considered severe. Only patients in the EL group reported alcohol consumption. However, in the more cephalad segments, the neural elements occupy a larger section of the spinal canal thus; a smaller area of epidural fat can produce severe compression as in the upper lumbar spine Figure 2 D.

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A literature search revealed only two cases of SEL associated with scoliosis 39. Liopmatosis D. The response to stress, as formulated by Selye [ 31 ], causes the release of corticotrophin by the pituitary; cortisol, epinephrine and other hormones by the adrenal gland. Both T-test and WMW test had p-values of 0. Nouv Press Med 8: —, Sandberg D, Lavyne M Symptomatic spinal epidural lipomatosis after local epidural corticosteroid injections: case report.

Adults in all age groups can be affected and present with progressive signs and symptoms of spinal cord or cauda equina compression. Download references. Find articles by Seok Won Kim. In a obese patient with radicular pain or progressive paralysis, SEL may be the etiologic factor involved. Immediate online access to all issues from

Interestingly, in another study, the EF hypotbyroidism was shown to epidural lipomatosis hypothyroidism in the thoracic spine in patients with adolescent idiopathic scoliosis AIS [ 26 ]. Rent this article via DeepDyve. Download other formats More. Thus, removal of some of the excessive epidural adipose tissue may be helpful to achieve an improved neurological status.

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