Elsberg Syndrome: One of the Causes of Cauda Equina Syndrome - A Case Series and Review of the Literature
Abstract
Elsberg syndrome (ES) is a rare syndrome characterized by acute or subacute lumbosacral radiculitis and myelitis confined to the lower spinal
cord, following an acute or reactivation viral infection. Reported complaints are urinary retention, bowel incontinence, radicular pain and muscle
weakness. It is associated with Herpes simplex type 2 infections or reactivation from dorsal root ganglia, there are also cases reported with acute
west Nile virus, varicella zoster virus and severe acute respiratory syndrome coronavirus 2. Clinicians do not generally consider this syndrome in
the differential diagnosis of acute cauda equina syndrome, and therefore, appropriate diagnostic approaches are missed. Sarcoidosis, lymphoma,
vasculitis, other sources of infection and dural arteriovenous fistula are also included in the differential diagnosis.
In order to draw attention to ES, which is a post viral inflammatory condition, two cases presenting acute cauda equina syndrome findings and
diagnosed with ES will be presented.
Keywords
Elsberg Syndrome, Herpes Simplex Type 2, Miyelitis
Ethical Statement
Informed consent taken from patients.
References
- 1. Hawkes MA, Toledano M, Kaufmann TJ, et al. West Nile Neuroinvasive Disease Presenting as Elsberg Syndrome. Neurologist. 2018;23:152-154.
- 2. Savoldi F, Kaufmann TJ, Flanagan EP, et al. Elsberg syndrome: A rarely recognized cause of cauda equina syndrome and lower thoracic myelitis. Neurol Neuroimmunol Neuroinflamm. 2017;4:e355.
- 3. Abrams RMC, Desland F, Lehrer H, et al. A Case of Elsberg Syndrome in the Setting of Asymptomatic SARS-CoV-2 Infection. J Clin Neuromuscul Dis. 2021;22:228-231.
- 4. Suarez-Calvet M, Rojas-Garcia R, Querol L, et al. Polyradiculoneuropathy associated to human herpesvirus 2 in an HIV-1-infected patient (Elsberg syndrome): case report and literature review. Sex Transm Dis. 2010;37:123- 125.
- 5. Yoritaka A, Ohta K, Kishida S. Herpetic lumbosacral radiculoneuropathy in patients with human immunodeficiency virus infection. Eur Neurol. 2005;53:179-181.
- 6. Santos DH, Carneiro de Oliveira RM, Junior WRF, et al. Myelorradiculitis due to Varicella Zoster (Elsberg syndrome) as the first symptom of HIV in a patient with Crohn’s disease in use of Infliximab. Mult Scler Relat Disord. 2021;47:102643.
- 7. Bhagat YV, Yunasan E, Alzedaneen Y, et al. Treatment of Elsberg Syndrome Causes Fever of Unknown Origin Attributable to Drug Reaction. Cureus. 2021;13:e18510.
- 8. Choudhury NA, Castrodad-Molina RM, Hutton GJ, et al. Elsberg syndrome following acute immunosuppressive treatment for multiple sclerosis relapse. Mult Scler Relat Disord. 2022;58:103498.
- 9. Saito H, Ebashi M, Kushimoto M, et al. Elsberg syndrome related to varicella zoster virus infection with painless skin lesions in an elderly woman with poorly controlled type 2 diabetes mellitus. Ther Clin Risk Manag. 2018;14:1951-1954.
- 10. Desai R, Welsh CT, Schumann SO 3rd. Elsberg Syndrome, Lumbosacral Radiculopathy, and Myelitis Due to Herpes Zoster in a Patient With Smoldering Myeloma. J Investig Med High Impact Case Rep. 2022;10:23247096211063348.