Froin’s syndrome with tuberculosis myelitis and spinal block

Mantese, Carlos Eduardo Aliatti; Lubini, Ricardo

doi:10.1590/1806-9282.20190536

Cited by 2 publications

(1 citation statement)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…CSF in patients with tuberculous myelitis characteristically revealed markedly raised protein levels indicating the presence of tuberculous spinal involvement [27]. The CSF GeneXpert MTB/RIF was positive in 3 of our cases, the bacteriological confirmation of extra-pulmonary tuberculosis is often difficult due to the paucibacillary nature of the disease [28].…”

Section: Discussionmentioning

confidence: 64%

Tuberculous myelitis: a prospective follow-up study

et al. 2022

View full text Add to dashboard Cite

Background Prospective studies regarding tuberculous myelitis are lacking. We aimed to prospectively evaluate patients with tuberculous myelitis to identify the features that distinguish tuberculous myelitis from other myelitis. Methods This was a prospective study. Patients presenting with paraparesis/quadriparesis, and MRI showing myelitis were included. All patients were subjected to clinical, neuroimaging, and laboratory evaluation. Diagnosis of definite tuberculous myelitis was made if GeneXpert test in CSF was positive. Probable tuberculous myelitis was diagnosed if there was evidence of tuberculosis elsewhere in the body. Patients were treated with methylprednisolone and antituberculosis treatment. Patients were followed for 6 months. We compared the clinical, laboratory, and neuroimaging parameters and response to treatment of tuberculous myelitis with other myelitis. P values were adjusted using the Benjamini-Hochberg (BH) procedure to control false discovery rate. ResultsWe enrolled 52 patients. Eighteen (34.6%) patients had tuberculous myelitis. Headache (P = 0.018) was significantly more common in tuberculous myelitis. The CSF protein (P < 0.001), and CSF cell count (P < 0.001) were significantly higher in tuberculous myelitis. On neuroimaging, a LETM was common in tuberculous myelitis. Spinal meningeal enhancement (14; 77.8%), extra-axial collection, and CSF loculation (6; 33.4%), arachnoiditis (3;16.7%), and concomitant spinal tuberculoma (2;11.1%) were other common imaging features of tuberculous myelitis. Tuberculous myelitis patients showed a better response (P = 0.025) to treatment. Conclusion Tuberculous myelitis was seen in approximately 35% of all myelitis cases, in a high tuberculosis endemic zone. Headache, markedly elevated CSF protein and spinal meningeal enhancement were distinguishing features. Tuberculous myelitis patients responded well to corticosteroids.

show abstract

Section: Discussionmentioning

confidence: 64%

Tuberculous myelitis: a prospective follow-up study

et al. 2022

View full text Add to dashboard Cite

show abstract

Froin’s Syndrome: A Comprehensive Review of the Literature and the Addition of Two New Cases

Jacobs,

Delsaut,

Lamartine S. Monteiro

et al. 2024

Neurology International

View full text Add to dashboard Cite

Background. Froin’s syndrome (FS) is a rare entity with uncertain prevalence and prognosis, defined by a pathognomonic triad: cerebrospinal fluid (CSF) xanthochromia, elevated protein levels in the CSF, and hypercoagulated CSF, usually obtained through lumbar puncturing below the level of a partial or complete spinal block. Methods. We conducted a comprehensive review of the literature on FS from its first description in 1903 to December 2023, utilizing PubMed and Google Scholar, and included two new cases from our clinical practice. Results. We describe two patients who suffered from Froin’s syndrome secondary to spinal abscesses. According to our review, FS is caused by neoplasia in 33% of cases, non-malignant mechanical causes in 27%, infections in 27%, non-infectious inflammatory processes in 6%, and vascular in 6%. The most prevalent symptoms are paraplegia/paraparesis (64%), back pain (38%), altered mental state and/or confusion (23%), sciatica (17%), headaches (17%), leg sensory defects (17%), and urinary retention (14%), and are thought to be linked with the underlying causes rather than the CSF characteristics. FS holds a poor prognosis: only 22% recuperate fully after treatment, 22% die due to the cause leading to FS, and 14% retain sequelae. Conclusions. Xanthochromia and proteinorachia >500 mg/dL are not specific to any single pathological condition, but indicate defective CSF recirculation and spinal block, causing diffusive and/or inflammatory processes resulting in the hyperproteinosis and coagulation of the CSF. We reviewed the pathophysiology, etiologies, symptoms, outcomes, and workups of Froin’s syndrome according to the existing medical literature.

show abstract

Froin’s syndrome with tuberculosis myelitis and spinal block

Cited by 2 publications

References 18 publications

Tuberculous myelitis: a prospective follow-up study

Tuberculous myelitis: a prospective follow-up study

Froin’s Syndrome: A Comprehensive Review of the Literature and the Addition of Two New Cases

Contact Info

Product

Resources

About