Cauda Equina Involvement in Post-Radiation Lower Motor Neuron Syndrome

Matsuda, Nozomu; Kobayashi, Shunsuke; Matsumoto, Hideyuki; Machii, Masayo; Soeda, Tomoko; Ugawa, Yoshikazu

doi:10.2169/internalmedicine.54.4182

Cited by 2 publications

(1 citation statement)

References 17 publications

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“… 74 75 76 The CECT is also prolonged in other peripheral neuropathies, such as POEMS (polyneuropathy, organomegaly, endocrinopathy, monoclonal plasma cell disorder, skin changes) syndrome, 77 anti-myelin-associated glycoprotein polyneuropathy, 48 tumor invasion, 24 and postradiation lower motor neuron syndrome. 78 …”

Section: Peripheral Nervous Systemmentioning

confidence: 99%

Central and Peripheral Motor Conduction Studies by Single-Pulse Magnetic Stimulation

Matsumoto,

Ugawa

2024

J Clin Neurol

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Single-pulse magnetic stimulation is the simplest type of transcranial magnetic stimulation (TMS). Muscle action potentials induced by applying TMS over the primary motor cortex are recorded with surface electromyography electrodes, and they are called motor-evoked potentials (MEPs). The amplitude and latency of MEPs are used for various analyses in clinical practice and research. The most commonly used parameter is the central motor conduction time (CMCT), which is measured using motor cortical and spinal nerve stimulation. In addition, stimulation at the foramen magnum or the conus medullaris can be combined with conventional CMCT measurements to evaluate various conduction parameters in the corticospinal tract more precisely, including the cortical–brainstem conduction time, brainstem–root conduction time, cortical–conus motor conduction time, and cauda equina conduction time. The cortical silent period is also a useful parameter for evaluating cortical excitability. Single-pulse magnetic stimulation is further used to analyze not only the central nervous system but also the peripheral nervous system, such as for detecting lesions in the proximal parts of peripheral nerves. In this review article we introduce four types of single-pulse magnetic stimulation—of the motor cortex, spinal nerve, foramen magnum, and conus medullaris—that are useful for the diagnosis, elucidation of pathophysiology, and evaluation of clinical conditions and therapeutic effects. Single-pulse magnetic stimulation is a clinically useful technique that all neurologists should learn.

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Section: Peripheral Nervous Systemmentioning

confidence: 99%

Central and Peripheral Motor Conduction Studies by Single-Pulse Magnetic Stimulation

Matsumoto,

Ugawa

2024

J Clin Neurol

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Delayed radiation-induced motor neuron syndrome: A case report

Giray,

Karayigit,

Senocak

et al. 2023

BMR

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BACKGROUND: Delayed radiation-induced motor neuron syndrome (DRIMNS) is an atypical motor neuron disorder that develops months or years after radiation therapy. In this study we present a case of DRIMNS that developed forty years after radiotherapy and to discuss differential diagnoses. CASE PRESENTATION: A 56-year-old male patient was admitted to our clinic with complaints of increasing difficulty in walking for the past year. He had a history of operation and radiotherapy due to testicular tumor. Electroneuromyography (ENMG) and thoracic, lumbosacral, plexus and pelvic magnetic resonance imaging (MRI) were performed considering radiculopathy, plexopathy and motor neuron disease in the differential diagnosis. MRIs revealed no abnormality. Needle EMG of lower extremity and lumbar paraspinal muscles revealed fibrillation and positive sharp waves concomitant with fasciculations and reduced recruitment suggesting anterior horn cell/root involvement. DRIMNS was considered rather than motor neuron disease based on the long duration of symptoms with slow progressive course and history of radiotherapy to the pelvic region. CONCLUSION: DRIMNS is a rare entity that should be considered in the differential diagnosis of lower extremity muscle weakness in a patient with a history of malignancy and radiotherapy. EMG findings are very valuable in making the diagnosis together with the clinical picture.

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Cauda Equina Involvement in Post-Radiation Lower Motor Neuron Syndrome

Cited by 2 publications

References 17 publications

Central and Peripheral Motor Conduction Studies by Single-Pulse Magnetic Stimulation

Central and Peripheral Motor Conduction Studies by Single-Pulse Magnetic Stimulation

Delayed radiation-induced motor neuron syndrome: A case report

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