Related Subjects:
|Transverse myelitis
|Acute Disseminated Encephalomyelitis
|Cervical spondylosis
|Spinal Cord Anatomy
|Acute Disc Prolapse
|Spinal Cord Compression
|Spinal Cord Haematoma
|Foix-Alajouanine syndrome
|Cauda Equina
|Conus Medullaris syndrome
|Anterior Spinal Cord syndrome
|Central Spinal Cord syndrome
|Brown-Sequard Spinal Cord syndrome
🧠 Foix-Alajouanine Syndrome is a rare and severe form of spinal dural arteriovenous fistula (SDAVF).
It represents a subacute necrotizing myelopathy due to venous congestion and thrombosis within the spinal cord.
This progressive condition can mimic other causes of myelopathy and, if untreated, leads to severe disability. ⚡
ℹ️ About
- Subtype of spinal dural AVF presenting as necrotizing myelopathy.
- Causes venous hypertension → chronic cord ischaemia → progressive neurological decline.
- Named after French neurologists Foix and Alajouanine (1926).
⚠️ Aetiology
- An extreme form of spinal dural AVF affecting a minority of patients.
- Abnormal shunting of blood from arterial to venous system leads to venous stasis and cord injury.
🩺 Clinical Features
- Progressive weakness: Gradual paraparesis starting in legs, ascending upwards.
- Sensory loss: Numbness, tingling, or sensory level deficit.
- Gait disturbance: Spastic or unsteady gait, dragging of feet.
- Back pain: Chronic lower back pain radiating to legs.
- Bladder & bowel dysfunction 🚽: Incontinence or retention.
- Spasticity: Stiffness, spasms, hyperreflexia in lower limbs.
🔬 Investigations
- MRI spine: Preferred modality → shows cord oedema, venous congestion, T2 hyperintensity.
- MRA: Helps visualise abnormal fistula and feeding vessels.
- Spinal angiography 🎯: Gold standard for diagnosis and surgical/endovascular planning.
- CSF (lumbar puncture): May show elevated protein; nonspecific.
💊 Management
- Surgical ligation ✂️: Definitive closure of the fistula to restore venous drainage.
- Endovascular embolization 🩸: Catheter-based occlusion using coils, glue, or embolic agents (minimally invasive).
- Supportive therapy: Physiotherapy, pain management, rehabilitation for residual deficits.
📚 Key Point
- Foix-Alajouanine Syndrome is essentially progressive venous myelopathy due to untreated SDAVF → requires early recognition and urgent intervention to prevent irreversible disability.
