Intradural Conus Medullaris Lipoma With Neurological Deficit: A Rare Occurrence

Abstract

Intradural lipoma without spinal dysraphism is a rare occurrence. Most of them are asymptomatic but can also present with neurological deficits. A 54-year-old male patient presented to us with progressive weakness in both lower limbs for six months. On physical examination and radiological workup, intradural lipoma was diagnosed. Due to progressive neurological deficit, the patient was treated surgically. On 2.5 years of follow-up, the patient showed complete neurological recovery. Intradural lipomas can also present with the neurological deficit at any age and should be managed surgically if the deficit is progressive in nature. Surgical management has a good outcome if done within two years of onset of symptoms.

Role of zinc in health and disease

“…Early manifestation includes neutropenia, leukopenia and anaemia [154]. This anaemia is likely due to the disruption of copper's physiological role in the differentiation of haematopoietic stem cells as well as intestinal iron absorption [156].…”

“…Under physiological conditions, copper plays a vital role in the synthesis and stabilisation of myelin, and in several enzymatic pathways required for the functioning of the nervous system. Therefore, if ZICD is left undiagnosed, it can lead to severe and permanent neurological complications including gait disturbances, paraesthesia and myelopathy [156].…”

“…Removal of the source of excess zinc along with oral copper gluconate treatment is often sufficient to revert anaemia, neutropenia and leukopenia seen in ZICD. Neurological deficits may also improve with this treatment; however, many never fully recover and will be left with permanent neurological deficits [156].…”