Arachnoiditis

The clinical picture of arachnoiditis unfolds after a significant period of time from the influence of the factor that caused it. This time is determined by the ongoing autoimmune processes and may differ depending on what exactly caused the arachnoiditis. So, after suffering from the flu, arachnoiditis manifests itself 3-12 months later, and after a traumatic brain injury, on average, after 1-2 years. In typical cases, arachnoiditis is characterized by a gradual, subtle onset with the appearance and increase of symptoms characteristic of asthenia or neurasthenia: increased fatigue, weakness, sleep disturbances, irritability, increased emotional lability. Against this background, the appearance of epileptic seizures is possible. Over time, cerebral and local (focal) symptoms accompanying arachnoiditis begin to appear.

General cerebral symptoms of arachnoiditis

General cerebral symptoms are caused by impaired cerebrospinal fluid dynamics and in most cases manifest themselves as cerebrospinal fluid hypertension syndrome. In 80% of cases, patients with arachnoiditis complain of a fairly intense bursting headache, most pronounced in the morning and aggravated by coughing, straining, and physical effort. Increased intracranial pressure is also associated with pain when moving the eyeballs, a feeling of pressure on the eyes, nausea, and vomiting.

Arachnoiditis is often accompanied by tinnitus, decreased hearing and non-systemic dizziness, which requires the patient to exclude ear diseases (cochlear neuritis, chronic otitis media, adhesive otitis, labyrinthitis). Excessive sensory excitability (poor tolerance of sharp sounds, noise, bright light), autonomic disorders and autonomic crises typical for vegetative-vascular dystonia may occur.

Often, arachnoiditis is accompanied by a periodically occurring sharp worsening of liquor-dynamic disorders, which clinically manifests itself in the form of a liquor-dynamic crisis - a sudden attack of intense headache with nausea, dizziness and vomiting. Such attacks can occur up to 1-2 times a month (arachnoiditis with rare crises), 3-4 times a month (arachnoiditis with moderate crises) and more than 4 times a month (arachnoiditis with frequent crises). Depending on the severity of symptoms, liquorodynamic crises are divided into mild, moderate and severe. A severe liquorodynamic crisis can last up to 2 days, accompanied by general weakness and repeated vomiting.

Focal symptoms of arachnoiditis

The focal symptoms of arachnoiditis may vary depending on its predominant localization.

Convexital arachnoiditis can manifest as mild to moderate impairment of motor activity and sensation in one or both extremities on the opposite side. In 35% of cases, arachnoiditis of this localization is accompanied by epileptic seizures. Usually there is polymorphism of epileptic seizures. Along with primary and secondary generalized ones, psychomotor simple and complex seizures are observed. After an attack, temporary neurological deficits may occur.

Basilar arachnoiditis can be widespread or localized primarily in the opticochiasmatic region, anterior or middle cranial fossa. Its clinical picture is mainly due to damage to the I, III and IV pairs of cranial nerves located at the base of the brain. Signs of pyramidal insufficiency may occur. Arachnoiditis of the anterior cranial fossa often occurs with impaired memory and attention, and decreased mental performance. Opticochiasmatic arachnoiditis is characterized by a progressive decrease in visual acuity and narrowing of the visual fields. These changes are most often bilateral in nature. Opticochiasmatic arachnoiditis can be accompanied by damage to the pituitary gland located in this area and lead to the appearance of an endocrine metabolic syndrome similar to the manifestations of a pituitary adenoma.

Arachnoiditis of the posterior cranial fossa often has a severe course, similar to brain tumors of this location. Arachnoiditis of the cerebellopontine angle, as a rule, begins to manifest as damage to the auditory nerve. However, it may begin with trigeminal neuralgia. Then symptoms of central neuritis of the facial nerve appear. With arachnoiditis of the cistern magna, a pronounced liquor-hypertensive syndrome with severe liquor-dynamic crises comes to the fore. Cerebellar disorders are characteristic: coordination disorders, nystagmus and cerebellar ataxia. Arachnoiditis in the area of the cistern magna can be complicated by the development of occlusive hydrocephalus and the formation of a syringomyelitic cyst.

1.What is arachnoiditis and its causes?

Arachnoiditis

is a pain syndrome caused by inflammation of the arachnoid membrane of one of the membranes surrounding and protecting the nerves of the spinal cord. The main signs of arachnoiditis are severe stinging and burning pain, neurological problems.

Causes of arachnoiditis.

Inflammation of the arachnoid membrane - arachnoiditis - can lead to the formation of scar tissue and failure of the spinal nerves. Arachnoiditis can develop for one of the following reasons:

Direct damage to the spine.
Chemical exposure. It is believed that certain chemicals that were previously used for myelograms and injected into the area adjacent to the spinal cord and nerves could cause arachnoiditis. A similar effect is attributed to the substances included in the epidural injection.
Bacterial or viral infection. Some infections such as viral and fungal meningitis and tuberculosis can affect the spine.
Chronic compression of the spinal nerves. The cause of such compression may be osteochondrosis or extended spinal stenosis (narrowing of the spinal column).
Complication after spinal surgery or other invasive procedures in the back area.

A must read! Help with treatment and hospitalization!

Treatment of post-traumatic arachnoiditis in Saratov, Russia

Sarklinik provides treatment for arachnoiditis in Saratov , Russia, treatment of post-traumatic arachnoiditis using hardware and non-hardware techniques. With complex treatment, a significant improvement in the condition is possible. Sarklinik knows how to effectively treat arachnoiditis. Consultations, comprehensive medical care.

In any case, it is necessary to carry out differential diagnosis and establish a true diagnosis, and only then carry out treatment. Differential diagnosis is varied, it is necessary to exclude various diagnoses: somatoform autonomic dysfunction, vegetative-vascular dystonia, cerebral vascular atherosclerosis, arterial hypertension, hypertension, cerebral aneurysm, age-related changes, stress, auditory neuritis, neurosis, depressive neurosis, cervical osteochondrosis spine, anemia, diseases of the cardiovascular system, arrhythmia, kidney disease, brain tumors, diseases of the endocrine system, taking a number of medications, consequences of brain injuries, concussions, otosclerosis, labyrinthitis, tumors of the tympanic cavity, Meniere's disease, acute trauma, exostoses , fistula, autoimmune diseases, exposure to loud noises at work or at home, the effects of ototoxic drugs, temporomandibular joint diseases.

Of course, it is necessary to conduct an MRI of the brain, REG, EEG, MRI of the cervical spine, vascular angiography, audiogram, CBC, TAM, glycated hemoglobin, cholesterol, lipoproteins (lipoproteins).

Tinnitus (tinnitus) and noise in the head make it very difficult to live a full life, so you should definitely consult a doctor.

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Elimination of the disease

The disease cerebral arachnoiditis must be treated over a long period of time, in courses. To eliminate the source of infection, doctors prescribe antibiotics to their patients. The following tools are also used:

anti-inflammatory;
absorbable;
hyposensitizing;
dehydration, etc.

When intracranial pressure increases, diuretics (for example, Furosemide, Mannitol) and decongestants are needed. If patients experience seizures, doctors prescribe antiepileptic drugs. If necessary, symptomatic medications are used.

Causes of disability

It was said above that cerebral arachnoiditis can lead to disability. Thus, the disease provokes a limitation of life activity, that is, patients completely or partially lose the opportunity or ability to carry out the main components of everyday life. This happens for the following reasons:

Convulsive seizures. Sick people periodically lose control over their behavior. In this regard, life activity is limited and ability to work is impaired.
Deterioration of visual functions. In people suffering from cerebral arachnoiditis, visual acuity decreases and the field of vision narrows. They cannot work with small parts or perform their professional duties that require eye strain. Some people constantly need help from people around them due to blindness.
Disturbances of cerebrospinal fluid dynamics in the disease cerebral arachnoiditis. The consequences are the manifestation of hypertensive syndrome with repeated crises. Crises are accompanied by dizziness and disorientation.
Neurasthenia and concomitant vegetative dystonia. People's endurance to climatic factors decreases, and the ability to endure prolonged physical and mental stress is lost. Patients react negatively to loud sounds and too bright light.

Classification of the disease

Depending on the location of the pathological process, several types of disease are distinguished. One of them is spinal arachnoiditis. In this disease, inflammation occurs in the meninges that surround the spinal cord. Another type is cerebral arachnoiditis. It affects only the lining of the brain. Cerebrospinal arachnoiditis is characterized by a combination of the two above-mentioned types of disease.

There is another classification. According to it, there are the following types of illness, this is arachnoiditis:

posterior cranial fossa;
bases of the brain (basal);
convex surface of the cerebral hemispheres (convexital);
in the area of the optic chiasm (optic-chiasmal);
cerebellopontine angle.

Depending on the morphological changes, the following are distinguished:

sticky;
adhesive-cystic;
cerebral cystic arachnoiditis.

General cerebral symptoms

Cerebral arachnoiditis is characterized by certain clinical manifestations. First of all, the disease makes itself felt by general cerebral symptoms. Headache is common. It is strongest in the morning. In some people it is accompanied by nausea and vomiting.

Headache may worsen with tension, straining, or awkward movements. In addition to it, people with cerebral arachnoiditis report dizziness. In patients, memory deteriorates, irritability appears, fatigue quickly sets in, sleep is disturbed, and general weakness is observed.

4. Treatment of the disease

There is no cure as such for arachnoiditis. Treatment may be the same as for other chronic pain, where the goal is to relieve pain and other symptoms that directly affect quality of life

. Doctors often recommend a pain treatment program in combination with physiotherapy, exercise therapy and psychotherapeutic sessions. Surgical treatment for arachnoiditis is a controversial option because the results of surgery may not be as expected and will provide only short-term relief. Some patients benefit from steroid injections and electrical stimulation.

Types of brain arachnoiditis: signs and symptoms

Inflammation of the arachnoid mater is an autoimmune process.
The immune system’s own complexes provoke the pathological process. The clinical symptoms of severe arachnoiditis are quite typical for neurologists to make a diagnosis. Additional diagnostics are carried out by cisternography, electroencephalography, CT and MRI of the brain. Treatment is complex, including neuroprotectors, antiepileptic drugs, absorbent agents, and dehydration drugs.

Arachnoiditis, or chronic focal leptomeningitis