Definição e significado de Arachnoiditis

Arachnoiditis
Classification and external resources
Myelogram showing arachnoiditis in the lumbar spine
ICD-10	G03.9
ICD-9	320-322
DiseasesDB	22543
eMedicine	radio/49
MeSH	D001100

Arachnoiditis is a neuropathic disease caused by the inflammation of the arachnoid, one of the membranes that surround and protect the nerves 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.

  Symptoms

Inflammation of the arachnoid can lead to a host of painful and debilitating symptoms. Chronic pain is common, including neuralgia. 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.

  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 syringomyelia.

  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
• Arachnoiditis; Familial spinal arachnoiditis (subtype); Spinal tuberculous arachnoiditis (subtype) at NIH's Office of Rare Diseases
• Online 'Mendelian Inheritance in Man' (OMIM) Spinal arachnoiditis -182950
• Duke RJ, Hashimoto SA (April 1974). "Familial spinal arachnoiditis. A new entity". Arch. Neurol. 30 (4): 300–3. PMID 4816834. 
• Arachnoiditis Information Page at NINDS