Thirty-seven dissections have shown that the skin of the low back is innervated by the lateral branches of the dorsal rami of T12 and LI in 22 cases (60%) or T12 L1 and L2, in 10 cases (27%) or T12 L1 and L2 receiving an anastomosis from L3 in 5 cases (13%). The most medial nerve crossed the iliac crest through a rigid osseo-aponeurotic orifice located 7-8 cm from the midline which was seen compressing the nerve in 2 instances. This pattern of distribution may sometimes explain unilateral low back pain.

A 38 year old patient developed multiple cranial nerve palsy, seizures and progressive alteration in consciousness. CSF examination revealed tumor cells and a tentative diagnosis of leptomeningeal carcinomatosis from an unknown primary tumor was made. Treatment with intrathecal methotrexate and cranial radiation therapy was started without effect. At autopsy widespread leptomeningeal gliomatosis originating from a previously unknown astrocytoma of the hippocampus was found.

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This study supports WB-mMRI as a sensitive and feasible tool for detecting myopathy in BSS patients. Associated with electroneuromyography, it can better indicate when a muscle biopsy is needed and guide it when required. Rigorous radiological interpretation is mandatory, so as not to miss incidental findings of clinical consequence.

No abstract