Arachnoiditis

Description

Arachnoiditis is an inflammatory response of the arachnoid, one of three coverings, or meninges, that envelop the brain and spinal cord. It may result from infection (including syphilis and tubercular meningitis), or trauma (including that resulting from surgery, lumbar puncture, and spinal anaesthesia). This condition is better known as Spinal (Adhesive) Arachnoiditis and may result in severe painful and debilitating conditions.

Prognosis

There is no cure for arachnoiditis. For the majority of patients, arachnoiditis is a disabling disease causing intractable pain and neurological deficits. As the disease progresses, some symptoms may increase and become permanent. Few people with this disorder are able to continue working. In some cases, progressive paraplegia may occur.

Treatment

The goal of treatment should be to return the patient to a functional role in society. Conservative therapy such as intensive pain management is generally recommended. In those patients whose arachnoiditis is progressive, surgery to remove adhesions is only minimally effective because scar tissue continues to develop. The surgery may expose the already irritated spinal cord to additional trauma and further aggravation of the condition.

Reviewed by Dr Andrew Rose-Innes, Yale University School of Medicine, 2007