Arachnoiditis
Encyclopedia
Arachnoiditis is a neuropathic disease caused by the inflammation
of the arachnoid
, one of the membranes
that surround and protect the nerve
s of the central nervous system, including the brain and spinal cord
. The arachnoid can become severely inflamed because of adverse reactions to chemicals, infection from bacteria
or viruses, as the result of direct injury to the spine, chronic compression of spinal nerves, or complications from spinal surgery or other invasive spinal procedures. Inflammation can sometimes lead to the formation of scar
tissue and adhesions which can cause the spinal nerves to "stick" together. This can be extremely painful especially if the last stage "Adhesive Arachnoiditis" is diagnosed, although clinical findings may not match pain levels. In other words it may appear mild on an MRI scan but the patient may be experiencing a great amount of pain.
. Numbness and tingling of the extremities is frequent in patients due to spinal cord involvement. Bowel, bladder, and sexual functioning can be affected if the lower part of the spinal cord is affected. While arachnoiditis has no consistent pattern of symptoms, it frequently affects the nerves that supply the legs and lower back. Many sufferers find themselves unable to sit for long (or even short) periods of time, often due to severe pain as well as efferent neurological symptoms, such as difficulties controlling limbs. This can be particularly problematic for those patients who exhibit difficulties standing or walking for protracted periods, as wheelchairs are not helpful for this group. Some sufferers benefit from relatively new inventions, such as the Segway
or the less expensive Stand'n'Ride alternative. Standing wheelchairs are also available, although often quite expensive and limited compared to these alternatives. However, standing endurance and vibration tolerance should be taken into account before a motorized assistance device is selected.
It is critical for patients to realize that the symptoms of arachnoiditis are highly varied and are not all experienced by all sufferers. Consequently, while typically significantly life-altering, the outcome, especially with physical therapy, appropriate psychotherapy, and medication, may be better than many patients fear upon receiving the diagnosis.
.
Worth mentioning here is the fact that many doctors are unfamiliar with arachnoiditis and order treatments that worsen the patients condition believing it is a common disc or nerve impingement problem. Patients may be wise to see a physician with experience in this area, though many doctors call themselves specialist while not being aware of the disastrous outcomes ordering even routine procedures can cause. Patient education is a must here.
Inflammation
Inflammation is part of the complex biological response of vascular tissues to harmful stimuli, such as pathogens, damaged cells, or irritants. Inflammation is a protective attempt by the organism to remove the injurious stimuli and to initiate the healing process...
of the arachnoid
Meninges
The meninges is the system of membranes which envelopes the central nervous system. The meninges consist of three layers: the dura mater, the arachnoid mater, and the pia mater. The primary function of the meninges and of the cerebrospinal fluid is to protect the central nervous system.-Dura...
, one of the membranes
Biological membrane
A biological membrane or biomembrane is an enclosing or separatingmembrane that acts as a selective barrier, within or around a cell. It consists of a lipid bilayer with embedded proteins that may constitute close to 50% of membrane content...
that surround and protect the nerve
Nerve
A peripheral nerve, or simply nerve, is an enclosed, cable-like bundle of peripheral axons . A nerve provides a common pathway for the electrochemical nerve impulses that are transmitted along each of the axons. Nerves are found only in the peripheral nervous system...
s of the central nervous system, including the brain and spinal cord
Spinal cord
The spinal cord is a long, thin, tubular bundle of nervous tissue and support cells that extends from the brain . The brain and spinal cord together make up the central nervous system...
. The arachnoid can become severely inflamed because of adverse reactions to chemicals, infection from bacteria
Bacteria
Bacteria are a large domain of prokaryotic microorganisms. Typically a few micrometres in length, bacteria have a wide range of shapes, ranging from spheres to rods and spirals...
or viruses, as the result of direct injury to the spine, chronic compression of spinal nerves, or complications from spinal surgery or other invasive spinal procedures. Inflammation can sometimes lead to the formation of scar
Scar
Scars are areas of fibrous tissue that replace normal skin after injury. A scar results from the biological process of wound repair in the skin and other tissues of the body. Thus, scarring is a natural part of the healing process. With the exception of very minor lesions, every wound results in...
tissue and adhesions which can cause the spinal nerves to "stick" together. This can be extremely painful especially if the last stage "Adhesive Arachnoiditis" is diagnosed, although clinical findings may not match pain levels. In other words it may appear mild on an MRI scan but the patient may be experiencing a great amount of pain.
Symptoms
Inflammation of the arachnoid can lead to a host of painful and debilitating symptoms. Chronic pain is common, including neuralgiaNeuralgia
Neuralgia is pain in one or more nerves that occurs without stimulation of pain receptor cells. Neuralgia pain is produced by a change in neurological structure or function rather than by the excitation of pain receptors that causes nociceptive pain. Neuralgia falls into two categories: central...
. Numbness and tingling of the extremities is frequent in patients due to spinal cord involvement. Bowel, bladder, and sexual functioning can be affected if the lower part of the spinal cord is affected. While arachnoiditis has no consistent pattern of symptoms, it frequently affects the nerves that supply the legs and lower back. Many sufferers find themselves unable to sit for long (or even short) periods of time, often due to severe pain as well as efferent neurological symptoms, such as difficulties controlling limbs. This can be particularly problematic for those patients who exhibit difficulties standing or walking for protracted periods, as wheelchairs are not helpful for this group. Some sufferers benefit from relatively new inventions, such as the Segway
Segway PT
The Segway PT is a two-wheeled, self-balancing transportation machine invented by Dean Kamen. It is produced by Segway Inc. of New Hampshire, USA. The name "Segway" is a homophone of "segue" while "PT" denotes personal transporter....
or the less expensive Stand'n'Ride alternative. Standing wheelchairs are also available, although often quite expensive and limited compared to these alternatives. However, standing endurance and vibration tolerance should be taken into account before a motorized assistance device is selected.
It is critical for patients to realize that the symptoms of arachnoiditis are highly varied and are not all experienced by all sufferers. Consequently, while typically significantly life-altering, the outcome, especially with physical therapy, appropriate psychotherapy, and medication, may be better than many patients fear upon receiving the diagnosis.
Prognosis
Arachnoiditis is a chronic disorder and there is no known cure at this time. Pain management techniques may provide some relief to patients. Prognosis may be hard to determine because of the lack of correlation between the beginning of the disease and the start of symptoms. For many, arachnoiditis is a disabling disease that causes chronic pain and neurological deficits. It may also lead to other spinal cord conditions, such as syringomyeliaSyringomyelia
Syringomyelia is a generic term referring to a disorder in which a cyst or cavity forms within the spinal cord. This cyst, called a syrinx, can expand and elongate over time, destroying the spinal cord. The damage may result in pain, paralysis, weakness, and stiffness in the back, shoulders, and...
.
Treatment
Arachnoiditis is a difficult condition to treat. Treatment is limited to alleviation of pain and other symptoms. Surgical intervention generally has a poor outcome and only provides temporary relief. Steroid injections administered either intrathecally or epidurally have been linked as a cause of the disease, therefore they are generally discouraged as a treatment and may even worsen the condition. Doctors have different views about this disease so seeking a different opinion may be wise.Worth mentioning here is the fact that many doctors are unfamiliar with arachnoiditis and order treatments that worsen the patients condition believing it is a common disc or nerve impingement problem. Patients may be wise to see a physician with experience in this area, though many doctors call themselves specialist while not being aware of the disastrous outcomes ordering even routine procedures can cause. Patient education is a must here.
External links
- Arachnoiditis
- http://www.burtonreport.com/InfSpine/AdhesArachAnatomy.htm