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20-September-2008 10:08:29 - Arachnoiditis February 2007 Arachnoiditis Classification and external resources ICD-10 G03.9 ICD-9 320-322 DiseasesDB 22543 eMedicine radio/49 MeSH D001100 Arachnoiditis is a neuropathic disease caused by the inflammation of the arachnoid, one of the membranes that surround and protect the nerves of the central nervous system, including the brain and spinal cord. The arachnoid can become severely inflamed because of adverse reactions to chemicals, blood, and/or steroids, infection from bacteria or viruses, as the result of direct injury to the spine, chronic compression of spinal nerves, or complications from spinal surgery or other invasive spinal procedures. Lumbar patches also known as blood patches, which are often useful in relieving painful headaches associated with spinal taps and epidural anesthesia, have been found to be significant potential causative agents in some cases and may warrant avoidance of the procedure where possible. Multiple blood patches may amplify the probability of contracting arachnoiditis. It is also noteworthy that blood has been found to be a significant inflammatory agent in the nervous system. Inflammation can sometimes lead to the formation of scar tissue and adhesions which can cause the spinal nerves to stick together. Contents 1 Symptoms 2 Prognosis 3 Treatment 4 Current research 5 External links Symptoms The swollen arachnoid can lead to a host of painful and debilitating symptoms. Chronic pain is common, including neuralgia. Numbness and tingling of the extremities is frequent in patients due to spinal cord involvement. Bowel, bladder, and sexual functioning can be affected if the lower part of the spinal cord is affected. While arachnoiditis has no consistent pattern of symptoms, it frequently affects the nerves that supply the legs and lower back. Many sufferers find themselves unable to sit for long or even short periods of time, often due to severe pain as well as efferent neurological symptoms, such as difficulties controlling limbs. This can be particularly problematic for those patients who exhibit difficulties standing or walking for protracted periods, as wheelchairs are not helpful for this group. Some sufferers benefit from relatively new inventions, such as the Segway or the less expensive Stand'n'Ride alternative. Standing wheelchairs are also available, although often quite expensive and limited compared to these alternatives. However, standing endurance and vibration tolerance should be taken into account before a motorized assistance device is selected. It is critical for patients to realize that the symptoms of arachnoiditis are highly varied and are not all experienced by all sufferers. Consequently, while typically significantly life-altering, the outcome, especially with physical therapy, appropriate psychotherapy, and medication, may be better than many patients fear upon receiving the diagnosis. Prognosis Arachnoiditis is a chronic disorder and there is no known cure at this time. Pain management techniques may provide some relief to patients. Prognosis may be hard to determine because of the lack of correlation between the beginning of the disease and the start of symptoms. For many, arachnoiditis is a disabling disease that causes chronic pain and neurological deficits. It may also lead to other spinal cord conditions, such as syringomyelia. Treatment Arachnoiditis is a difficult condition to treat. Treatment is limited to alleviation of pain and other symptoms. Surgical intervention generally has a poor outcome and only provides temporary relief. Steroid injections administered either intrathecally or epidurally have been linked as a cause of the disease, therefore they are generally discouraged as a treatment and may even worsen the condition. Current research Recent research has indicated that a group of chemicals called cytokines that are produced by various cells in the body may be responsible for generating the pain response. Medications that affect the release of cytokines or block the action of cytokines may reduce the pain response. Various anti-cytokine medications are now being used to treat painful disease states such as Rheumatoid Arthritis and Crohn's Disease. In a recent study the anti-cytokine medication, Thalidomide, is being evaluated for its effect in treating pain associated with Arachnoiditis. External links Circle Of Friends With Arachnoiditis COFWA American Chronic Pain Association ACPA National Chronic Pain Outreach Association NCPOA National Institute of Arthritis and Musculoskeletal and Skin Diseases NIAMS National Institute of Dental and Craniofacial Research NIDCR Arachnoiditis Arachnoiditis, if you have ever suffered from back pain or know anyone who has then this is where to find help and information. Support for those with disorders of the Arachnoid Membrane http://www.burtonreport.com/InfSpine/AdhesArachAnatomy.htm http://groups.msn.com/DepoMedrolDidItHarmYou Did Depo-Medrol Cause Your Arachnoiditis? EDNC v d e Pathology of the nervous system, primarily CNS G00-G47, 320-349 Inflammatory Meningitis Arachnoiditis - Encephalitis - Myelitis - Encephalomyelitis Acute disseminated - Tropical spastic paraparesis - Cavernous sinus thrombosis Systemic atrophies Huntington's disease - Spinocerebellar ataxia Friedreich's ataxia, Ataxia telangiectasia, Herary spastic paraplegia - Spinal muscular atrophy: Werdnig-Hoffman - Kugelberg-Welander - Fazio-Londe - MND ALS, PMA, PBP, PP, PLS Extrapyramidal and movement disorders Parkinson's disease - Neuroleptic malignant syndrome - Postencephalitic parkinsonism - Pantothenate kinase-associated neurodegeneration - Progressive supranuclear palsy - Striatonigral degeneration - Dystonia/Dyskinesia Spasmodic torticollis, Meige's, Blepharospasm - Essential tremor - Myoclonus - Lafora - Chorea Choreoathetosis - Restless legs - Stiff person Other degenerative/ demyelinating diseases dementia: Alzheimer's - Pick's - Dementia with Lewy bodies - Frontotemporal lobar degeneration mitochondrial disease: Leigh's demyelinating: Multiple sclerosis - Devic's - Central pontine myelinolysis - Transverse myelitis - Marchiafava-Bignami disease - CAMFAK syndrome - Alpers' Seizure/epilepsy Focal - Generalised - Status epilepticus - Myoclonic epilepsy Headache Migraine Familial hemiplegic - Cluster - Vascular - Tension Vascular Transient ischemic attack Amaurosis fugax, Transient global amnesia Cerebrovascular disease MCA, ACA, PCA, Foville's, Millard-Gubler, Lateral medullary, Weber's, Lacunar stroke Sleep disorders Insomnia - Hypersomnia - Sleep apnea Obstructive, Ondine's curse - Narcolepsy - Cataplexy - Kleine-Levin - Circadian rhythm sleep - Delayed sleep phase - Advanced sleep phase Intracranial hypertension Hydrocephalus Normal pressure - Idiopathic intracranial hypertension Other encephalopathy Brain herniation - Cerebral edema - Reye's Other spinal cord disease Syringomyelia - Syringobulbia - Morvan's syndrome - Spinal cord compression Retrieved from http://en..org/wiki/Arachnoiditis Categories: Neurological disordersHidden categories: Articles lacking sources from February 2007 | All articles lacking sources Views Article Discussion this page History Personal tools Log in / create account Navigation Main page Contents Featured content Current events Random article Search Go Search Interaction Community portal Recent changes Contact Donate to Help Toolbox What links here Related changes Upload file Special pages Printable version Permanent link Cite this page This page was last modified on 29 June 2008, at 01:4
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