Postmyelographic Arachnoiditis: Causes, Symptoms, Treatment, Prognosis

Back pain has affected a majority of the population at some point in their lives or the other. Given the sedentary lifestyle that most of the modern population has adopted, this is not so surprising.¹ However, the pain might not simply be a consequence of the sedentary lifestyle- it might be an indicator of some other underlying issues. Postmyelographic arachnoiditis can be one of them.

The central nervous system of our body consisting of the brain, the spinal cord and the nerve roots is protected by a membrane which is defined as the arachnoid.² The inflammation of this membrane leads to a condition which is defined as arachnoiditis. This inflammation can occur in two membranes- the interior membrane termed as arachnoid and the external membrane termed as dura. When a person suffers from arachnoiditis post myelography study done by injecting Metrizamide or Iocarmate, it is known a postmyelographic arachnoiditis.

People suffering from the condition of postmyelographic arachnoiditis are likely to manifest the following signs and symptoms-

• An extreme sensation of pain in the lower back and legs accompanied by a numbness and weakness in the legs.
• Abnormalities in the gait.
• Muscle cramps, spasms and an uncontrollable twitching.
• The pain in the lower back also makes it difficult for patients suffering from Postmyelographic arachnoiditis to walk, sit or stand for prolonged periods of time.
• People are also likely to feel a sense of dizziness and nausea.
• Patients also suffer from headaches, a weakening vision and hearing difficulties as well.
• Bowel, bladder and sexual problems might also arise.

The root causative factor of postmyelographic arachnoiditis is yet unknown. Although, scientists have not yet got any direct causal relationship between myelographic studies done using aqueous contrast media like Metrizamide or Iocarmate and postmyelographic arachnoiditis, several studies have confirmed that some individuals along with animals do develop arachnoiditis several weeks after the study. However, the reason is yet not found for such an outcome.

Patients manifesting the signs and symptoms of Postmyelographic arachnoiditis are generally asked to undergo CAT or Computerized Axial Tomography and MRI or Magnetic Resonance Imaging in order to determine whether the patients are actually suffering from postmyelographic arachnoiditis as the symptoms may be an indicator of certain other diseases as well. Development of the disease following a myelography done with Metrizamide and Iocarmate also serves as a point to diagnose the condition. Upon confirmation, patients also need to undergo the EMG or Electromyogram test in order to determine the severity of the condition.

There is still no known cure for postmyelographic arachnoiditis. Focus is laid on the alleviation of the symptoms and reducing the pain to an extent. Medications are provided so as to reign in the acute pain that might affect the daily routine of the patients and mild physical therapies are also suggested in some of the cases. Other pain management programs are also recommended.

Postmyelographic arachnoiditis is more likely to affect people who have suffered injury to the spinal cord due to external forces and a myelogram is done using an aqueous contrast medium to diagnose injury.

Postmyelographic arachnoiditis is quite a rare disorder which might have severe consequences if left untreated. Though there is no complete cure for Postmyelographic arachnoiditis, the symptoms might be treated in order to overcome the problems the condition brings about in everyday situations.

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