According to FOODANDDRINKJOURNAL.COM, the Elsberg syndrome is an inflammatory disease of the lumbar spine and corresponds to a radiculoneuritis. The inflammation often affects the sacral nerve roots as well as the medullary cones and the cauda equina of the lower spinal cord. The prognosis for the syndrome is favorable.
What is Elsberg Syndrome?
In the disease group of polyradiculitis, several nerve roots are affected by inflammation. Pathohistological changes in the nerve tissue occur as part of the inflammation. Elsberg syndrome is also a polyradiculitis. The symptom complex is named after the US neurosurgeon Charles Elsberg, who first described the disease in the 20th century.
In the disease, the lower spinal cord, including the sacral nerve roots, becomes inflamed. These are the nerve roots of the sacrum at the back of the bony pelvis. The conus medullaris and the cauda equina in the lower spinal cord are also affected by inflammation. The medical terms polyradiculitis sacralis and radiculitis sacralis are used synonymously for Elsberg syndrome. So far, the Elsberg syndrome has not been conclusively researched. Elsberg’s original description has also been modified. For example, we are no longer talking about a chronically progressive disease, but rather a disease that is mostly regressive.
The exact cause of Elsberg syndrome has not yet been clarified. Presumably it is a variant of the Guillain-Barré syndrome. This is an acutely occurring clinical picture that is associated with inflammatory changes in the peripheral nervous system. The cause of Guillain-Barré syndrome also remains unknown.
The neurological disease is presumably caused by an autoimmune pathological mechanism that allows the body to produce autoantibodies against gangliosides and myelin. In the case of Elsberg’s syndrome, there is a connection with certain viral infections, for example with herpes simplex type 2, the cytomegalovirus, the HI virus and the Epstein-Barr virus.
Elsberg syndrome can, however, also occur in the larger context of neuroborreliosis. Other sources speak of an outbreak after circulatory disorders, in the context of vascular inflammation or worm infections.
Symptoms, ailments & signs
The clinical picture in patients with Elsberg syndrome corresponds to the so-called Konus-Kauda syndrome. A loss of sensitivity in the distal part of the spinal cord segment L3 is accompanied by radicular pain, which is often severe, and can result in flaccid paralysis of the legs. Typically, a bladder emptying or sexual dysfunction also occurs.
Rectum disorders can also be the result of Elsberg syndrome. Sensory disorders are often structured into lumbar and sacral dermatomes. Usually it is a question of paresthesias that are accompanied by an unpleasant, painful body sensation and are associated with tingling, numbness or falling asleep, as well as cold and heat perception disorders.
In most cases, symptoms appear quickly and suddenly. Reflective disorders such as the so-called pyramid orbit signs are rather untypical for Elsberg syndrome. Instead of a lesion of the pyramidal tracts, there is myelitis of the caudal sections of the spinal cord.
Diagnosis & course
For diagnosis, if Elsberg syndrome is suspected, the neurologist conducts a CSF examination and punctures the spinal cord in order to give the cerebral fluid of the outer ventricle for laboratory diagnostic examination. In Elsberg syndrome, laboratory diagnostic CSF analysis reveals cytoalbuminal dissociation, pleocytosis and an increase in IgG. Magnetic resonance imaging may be necessary to rule out space occupation.
In terms of differential diagnosis, the cone- cauda equina syndrome must also be considered, which is often associated with herniated discs in the lumbar spine or tumor masses. With Elsberg syndrome, the medical opinion on the course of the disease has changed since it was first described.
Elsberg described the disease as chronically progressive and gave a rather unfavorable course. However, the past has shown that it is usually not a progressive disease. In many of the cases observed, the symptoms have completely resolved again.
When should you go to the doctor?
In the event of sudden sensory disorders, bladder disorders or rectal disorders, a doctor should always be consulted. Although the symptoms do not necessarily indicate Elsberg’s syndrome, they are almost always based on a serious underlying condition that must be medically clarified and treated if necessary.
If symptoms such as tingling, numbness or slackness of the legs are added, Elsberg syndrome is likely – at the latest then a medical evaluation is required. If you have severe symptoms with Elsberg syndrome, you should consult an emergency doctor or the nearest hospital.
This is especially true for people who are already physically weakened by another illness. If they suddenly notice symptoms of Elsberg’s syndrome, an immediate emergency medical evaluation is required in any case. Otherwise, serious complications such as a herniated disc or sensitive cold and perceptual disorders can arise.
Further risk groups are patients with existing neuroborreliosis, circulatory disorders, vascular inflammation or worm infections. Patients with these and similar diseases should speak to their family doctor quickly if any of the symptoms mentioned are noticed.
Treatment & Therapy
In Elsberg syndrome, the therapy depends primarily on the underlying disease. The administration of immunoglobulins and corticosteroids can help relieve symptoms. As a variant of Guillain-Barré syndrome, Elsberg syndrome can be completely cured. An early diagnosis favors healing.
As with Guillain-Barré syndrome, mild forms of the disease are primarily about preventing thromboses and infections. As part of physiotherapy, the patient can regain muscle control after leg paresis. A disease of unexplained etiology is often perceived as a great shock by patients. The psychological stress can impair the success of physiotherapy.
Therefore, psychotherapeutic care can improve the chances of recovery. Immunotherapy is available for Guillain-Barré syndrome in acute and severe cases. This type of treatment can also be considered for patients with Elsberg syndrome. Either immunoglobulins are administered to the affected person as part of the therapy or plasmapheresis is used. Therapy with immunoglobulins is much gentler and less side effects than plasmapheresis.
However, this treatment is associated with high costs and is less effective in Guillain-Barré syndrome. Plasmapheresis is particularly suitable for rapidly progressing, long-lasting processes. A catheter is placed in the blood system. A machine pumps the patient’s blood out of and back into the body to cleanse immunoglobulins.
Outlook & forecast
Elsberg syndrome, which is controversial as a separate entity, usually shows a favorable course. It was originally described as a progressive disease by New York neurosurgeon Charles Elsberg. Today the picture is more nuanced. In most cases, symptoms have regressed. The cause of Elsberg Syndrome is not yet clear. So it is not certain whether it is just a complex of symptoms with several possible causes. The prognosis of the disease in each individual case depends on this.
Even the possible underlying diseases can differ in their course and prognosis. A connection between Elsberg’s syndrome and herpes simplex, cytomegalovirus or HIV virus infections as well as neuroborreliosis, but also worm infections, vascular inflammation or circulatory disorders is described.
Each of these diseases has its own course and thus influences the prognosis of the resulting Elsberg syndrome. Clinically, Elsberg syndrome resembles Konus-Kauda syndrome, which is noticeable through paralysis in herniated discs or space-occupying processes in tumors.
Elsberg syndrome is treated symptomatically with corticosteroids. However, permanent resolution of symptoms can only be achieved by treating the underlying condition. If no irreversible changes have occurred, symptoms can subside even without therapy after the underlying disease has healed. More rarely, as in the case described by Elsberg, there is a progressive chronic development of the symptoms.
The primary cause of Elsberg syndrome has not yet been conclusively clarified. For this reason, the symptom complex is difficult to prevent. However, since a quick diagnosis increases the chances of a favorable outcome, those affected should seek medical care at times and have even the smallest sensory disturbances in the lumbar spine clarified.
In most cases, follow-up care options for Elsberg syndrome are severely limited. The person concerned is primarily dependent on treatment by a doctor in order to alleviate the symptoms and prevent further complications. Since this cannot lead to self-healing, a medical examination and treatment must always be carried out.
Elsberg syndrome is usually treated with the help of medication. The patients are dependent on regular intake in order to alleviate the symptoms. In the case of children, parents should check the correct intake and, if in doubt or if anything is unclear, contact a doctor. Furthermore, infections should generally be prevented.
Since psychological treatment is not infrequently necessary for the person affected, the help and support of parents and one’s own family can have a very positive effect on the further course of Elsberg syndrome and prevent further psychological upsets. In general, the person concerned should take it easy and avoid exertion or stressful situations. It cannot be universally predicted whether the syndrome will lead to a reduced life expectancy for the patient.
You can do that yourself
For better healing or alleviation of inflammation, it is particularly helpful if the patient has a healthy and stable immune system. A balanced diet, sufficient exercise and the avoidance of harmful substances such as nicotine or drugs are important for this. A good health awareness promotes the physical resources that are needed to improve the symptoms.
The movement sequences should be optimized to prevent damage to the skeletal system. One-sided physical strain or misalignment of the bones should be avoided. Postures are not to be maintained in the same position for a long time. This puts an unnecessary strain on the body. Countermovements are helpful to compensate. In addition, sporting activities support muscle building and general well-being.
For emotional relief, it is advisable to have conversations with friends, relatives or those who are also affected. In a mutual exchange, the challenges of the day can be discussed and tips for how to better deal with the complaints can be given. If this is not enough, it is advisable for the patient to seek psychological help. In addition, as a balance in everyday life, the use of relaxation methods help to alleviate mental stress. With techniques such as meditation or yoga, the patient can stabilize his psyche and reduce stress from everyday life.