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Anterior Lumbar Radiculopathy
Kevin R. Moore, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Abbreviations

                • Methotrexate (MTX), cytosine arabinoside (Ara-C)
              • Definitions

                • Transient or permanent paraplegia
                • Uncommon complication following intrathecal chemotherapy
                • Initially described following intrathecal methotrexate (MTX) in pediatric acute lymphoblastic leukemia patients
                  • Subsequently reported with other chemotherapy agents and in adults

              IMAGING

              • General Features

                • MR Findings

                  • Imaging Recommendations

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        CLINICAL ISSUES

                        • Presentation

                          • Demographics

                            • Natural History & Prognosis

                              • Treatment

                                DIAGNOSTIC CHECKLIST

                                • Consider

                                  • Image Interpretation Pearls

                                    Selected References

                                    1. Draak TH et al: Changing outcome in inflammatory neuropathies: Rasch-comparative responsiveness. Neurology. ePub, 2014
                                    2. Ma YY et al: Guillain-Barré syndrome and severe infection following chemotherapy for peripheral T-cell lymphoma: A case report. Oncol Lett. 8(6):2695-2698, 2014
                                    3. Endo K et al: [An adult Guillain-Barré syndrome patient with enhancement of anterior roots on spinal MRI and severe radicular pain relieved by intravenous methylprednisolone pulse therapy: A case report.] Rinsho Shinkeigaku. 53(7):543-50, 2013
                                    4. Lee HY et al: Irreversible paraplegia following one time prophylactic intrathecal chemotherapy in an adult patient with acute lymphoblastic leukemia. Yonsei Med J. 49(1):151-4, 2008
                                    5. Pascual AM et al: Anterior lumbosacral polyradiculopathy after intrathecal administration of methotrexate. J Neurol Sci. 267(1-2):158-61, 2008
                                    6. Rison RA: Ascending sensory motor polyradiculoneuropathy with cranial nerve involvement following administration of intrathecal methotrexate and intravenous cytarabine in a patient with acute myelogenous leukemia: a case report*. Cases J. 1(1):255, 2008
                                    7. Santos-García D et al: Pure motor lumbosacral radiculopathy after intrathecal chemotherapy. Eur J Neurol. 15(8):e86-7, 2008
                                    8. Counsel P et al: Myelopathy due to intrathecal chemotherapy: magnetic resonance imaging findings. Clin Radiol. 62(2):172-6, 2007
                                    9. Rolf N et al: Acute ascending motoric paraplegia following intrathecal chemotherapy for treatment of acute lymphoblastic leukemia in children: case reports and review of the literature. Klin Padiatr. 218(6):350-4, 2006
                                    10. Bay A et al: Myelopathy due to intrathecal chemotherapy: report of six cases. J Pediatr Hematol Oncol. 27(5):270-2, 2005
                                    11. Umeda M et al: [Gadolinium enhancement of the anterior portion of the lumbosacral roots in a case of post-irradiation lumbosacral radiculopathy.] Rinsho Shinkeigaku. 45(10):758-61, 2005
                                    12. Anderson SC et al: Ventral polyradiculopathy with pediatric acute lymphocytic leukemia. Muscle Nerve. 25(1):106-10, 2002
                                    13. Koh S et al: Anterior lumbosacral radiculopathy after intrathecal methotrexate treatment. Pediatr Neurol. 21(2):576-8, 1999
                                    14. Vainionpää L et al: Chemotherapy for acute lymphoblastic leukemia may cause subtle changes of the spinal cord detectable by somatosensory evoked potentials. Med Pediatr Oncol. 28(1):41-7, 1997
                                    Related Anatomy
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                                    Related Differential Diagnoses
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                                    References
                                    Tables

                                    Tables

                                    KEY FACTS

                                    • Terminology

                                      • Imaging

                                        • Top Differential Diagnoses

                                          • Pathology

                                            • Clinical Issues

                                              • Diagnostic Checklist

                                                TERMINOLOGY

                                                • Abbreviations

                                                  • Methotrexate (MTX), cytosine arabinoside (Ara-C)
                                                • Definitions

                                                  • Transient or permanent paraplegia
                                                  • Uncommon complication following intrathecal chemotherapy
                                                  • Initially described following intrathecal methotrexate (MTX) in pediatric acute lymphoblastic leukemia patients
                                                    • Subsequently reported with other chemotherapy agents and in adults

                                                IMAGING

                                                • General Features

                                                  • MR Findings

                                                    • Imaging Recommendations

                                                      DIFFERENTIAL DIAGNOSIS

                                                        PATHOLOGY

                                                        • General Features

                                                          CLINICAL ISSUES

                                                          • Presentation

                                                            • Demographics

                                                              • Natural History & Prognosis

                                                                • Treatment

                                                                  DIAGNOSTIC CHECKLIST

                                                                  • Consider

                                                                    • Image Interpretation Pearls

                                                                      Selected References

                                                                      1. Draak TH et al: Changing outcome in inflammatory neuropathies: Rasch-comparative responsiveness. Neurology. ePub, 2014
                                                                      2. Ma YY et al: Guillain-Barré syndrome and severe infection following chemotherapy for peripheral T-cell lymphoma: A case report. Oncol Lett. 8(6):2695-2698, 2014
                                                                      3. Endo K et al: [An adult Guillain-Barré syndrome patient with enhancement of anterior roots on spinal MRI and severe radicular pain relieved by intravenous methylprednisolone pulse therapy: A case report.] Rinsho Shinkeigaku. 53(7):543-50, 2013
                                                                      4. Lee HY et al: Irreversible paraplegia following one time prophylactic intrathecal chemotherapy in an adult patient with acute lymphoblastic leukemia. Yonsei Med J. 49(1):151-4, 2008
                                                                      5. Pascual AM et al: Anterior lumbosacral polyradiculopathy after intrathecal administration of methotrexate. J Neurol Sci. 267(1-2):158-61, 2008
                                                                      6. Rison RA: Ascending sensory motor polyradiculoneuropathy with cranial nerve involvement following administration of intrathecal methotrexate and intravenous cytarabine in a patient with acute myelogenous leukemia: a case report*. Cases J. 1(1):255, 2008
                                                                      7. Santos-García D et al: Pure motor lumbosacral radiculopathy after intrathecal chemotherapy. Eur J Neurol. 15(8):e86-7, 2008
                                                                      8. Counsel P et al: Myelopathy due to intrathecal chemotherapy: magnetic resonance imaging findings. Clin Radiol. 62(2):172-6, 2007
                                                                      9. Rolf N et al: Acute ascending motoric paraplegia following intrathecal chemotherapy for treatment of acute lymphoblastic leukemia in children: case reports and review of the literature. Klin Padiatr. 218(6):350-4, 2006
                                                                      10. Bay A et al: Myelopathy due to intrathecal chemotherapy: report of six cases. J Pediatr Hematol Oncol. 27(5):270-2, 2005
                                                                      11. Umeda M et al: [Gadolinium enhancement of the anterior portion of the lumbosacral roots in a case of post-irradiation lumbosacral radiculopathy.] Rinsho Shinkeigaku. 45(10):758-61, 2005
                                                                      12. Anderson SC et al: Ventral polyradiculopathy with pediatric acute lymphocytic leukemia. Muscle Nerve. 25(1):106-10, 2002
                                                                      13. Koh S et al: Anterior lumbosacral radiculopathy after intrathecal methotrexate treatment. Pediatr Neurol. 21(2):576-8, 1999
                                                                      14. Vainionpää L et al: Chemotherapy for acute lymphoblastic leukemia may cause subtle changes of the spinal cord detectable by somatosensory evoked potentials. Med Pediatr Oncol. 28(1):41-7, 1997