Mark K. Lyons, MD
Potential Conflicts of Interest: None disclosed.
Lyons M.; Metastatic Breast Carcinoma Diagnosed by Nerve Root Biopsy for the Cauda Equina Syndrome. Ann Intern Med. 2010;153:550-551. doi: 10.7326/0003-4819-153-8-201010190-00022
Download citation file:
Published: Ann Intern Med. 2010;153(8):550-551.
Background: Lower-extremity weakness and numbness can be signs of the cauda equina syndrome. Causes of the syndrome include infectious, inflammatory, metabolic, structural, congenital, neoplastic, and psychological disorders. The usual diagnostic steps include recording patient history, conducting a neurologic examination, and performing appropriate noninvasive diagnostic testing (such as electromyography, cerebrospinal fluid analysis, and serologic testing).
Objective: To illustrate when a nerve root biopsy might identify the cause of the cauda equina syndrome.
Case Report: A 65-year-old woman developed paresthesia in her feet that progressed over 2 months. During the next 4 months, her symptoms included painless, progressive asymmetrical lower-extremity weakness and sensory loss. Her initial evaluation approximately 6 months after symptoms began included cerebrospinal fluid analysis; the only abnormal result was an elevated protein level of 6190 mg/L (normal range, 70 to 210 mg/L). Cytology results were negative for malignant lesions, and all serologic test results were normal. Electromyography results were normal except for a prolonged Hoffmann reflex. Initial brain and lumbar magnetic resonance imaging (MRI) results were unremarkable. Her physicians gave her doxycycline for 10 days and initiated prednisone therapy, 75 mg/d.
to gain full access to the content and tools.
Learn more about subscription options.
Register Now for a free account.
Copyright © 2016 American College of Physicians. All Rights Reserved.
Print ISSN: 0003-4819 | Online ISSN: 1539-3704
Conditions of Use
This PDF is available to Subscribers Only