Net Guide: Arachnoiditis

Pain Management, December 2010, Volume 3, Issue 8

A collection of links and resources from across the web focus on one specific condition. These resource range from useful websites to clinical trials.

//The Educated PatientTM

Arachnoiditis —

This site provides a detailed account of arachnoiditis, described here as a “debilitating condition characterized by severe stinging and burning pain and neurologic problems. It is caused by an inflammation of the arachnoid lining—one of the 3 linings that surround the brain and spinal cord.” Along with coverage of the common symptoms—including tingling, numbness, weakness in the legs, “bizarre sensations, severe shooting pain, muscle cramps, and bladder dysfunction—the site explores the three primary causes of the disease: Trauma/surgery, chemicals, and infection.

NINDS Arachnoiditis Information Page

Provided by the National Institute of Neurological Disorders and Stroke, this overview discusses causes of, treatment options for, prognosis of, and current research focused on arachnoiditis, along with information on organizations that patients can obtain help from. Although the condition is difficult to treat, the site explains that “a regimen of pain management, physiotheraphy, exercise, and psychotheraphy is often recommended.” Patients can check the site often for routinely updated resources.

Circle of Friends with Arachnoiditis (COFWA)

This patient-centered site serves as a support group for those suffering from arachnoiditis, providing helpful information for coping and living with the condition. Created in 1997, the site features a number of articles from medical experts and offers online community support. The mission of COFWA is “to foster an atmosphere of Caring, Friendship, Education, and Advocacy for the Support of those individuals, their families, friends and care givers living and coping with chronic intractable pain as a result of Arachnoiditis, it's progression as well as the myriad of ill consequence associated with Adhesive Arachnoiditis and related complications.” In the “More Arachnoiditis” section is an overview of adhesive arachnoiditis that explores the causes, why the condition is under-diagnosed, and related anatomy. Featured here is also the video documentary “Arachnoiditis - Fighting Back.”

A.S.A.M. Society

This comprehensive site offers information for both arachnoiditis patients and their caregivers. In the “About Arachnoiditis” section are a collection of articles that explain the condition and illustrations that help visualize its progression. This section also describes complications, such as arachnoid cysts and spine infections, and offers definitions, answers to frequently asked questions, medical procedure explanations, and more. Alternative treatments and patient stories are also highlighted at the site.

//Medical Websites

Complications of Spinal Surgery

Provided by SpineUniverse for professionals, this site serves as a resource to those interested in spinal cord injuries or complications arising from surgeries. Arachnoiditis is featured, including coverage of possible risk factors, symptoms, and diagnostic tests.


Tuberculous Optochiasmatic Arachnoiditis

Journal: Neurology India (September-October 2010)

Authors: Anupriya A, Sunithi M, Maya T, et al

Purpose: To evaluate “the clinical features, cerebrospinal fluid (CSF) and laboratory parameters and imaging findings of optochiasmatic arachnoiditis (OCA)” and “identify any factors which can predict this complication in patients with TBM.”

Results: The team analyzed data from more than six years on 163 patients admitted with tuberculous meningitis to neurology wards of a tertiary care teaching hospital. Of the patients analyzed, 14% developed OCA. Also, 78% of these patients “developed this complication while on antituberculous treatment (ATT) and 5/23 (22%) were newly diagnosed cases of TB.” The authors concluded that “OCA can develop even while on treatment with ATT. Young women with a high CSF protein content seem to be more prone for this complication.”

MRI Manifestations and Differentiated Diagnosis of Postoperative Spinal Complications

Journal: Journal of Huazhong Univeristy of Science and Technology (August 2009)

Authors: Yang H, Wang R, Luo T, et al

Purpose: The study was designed to analyze “MR manifestations of postoperative spinal complications and investigate the value of MRI in the diagnosis and differentiated diagnosis.”

Results: The researchers retrospectively analyzed “114 cases of spinal postoperative complications,” and compared them with the clinical data. Among the spinal complications found were spinal stenosis, lack of spinal stability, infection — including spinal arachnoiditis, and more. They concluded that “MRI can specifically display all kinds of postoperative spinal complications, and is of significant value in the diagnosis and differentiated diagnosis of postoperative spinal complications.”

Tuberculosis with Meningitis, Myeloradiculitis, Arachnoiditis and Hydrocephalus: A Case Report

Journal: Acta Neurologica Taiwan (Septemebr 18, 2010)

Authors: Liao P, Chiang T, Lee M, Huang C

Purpose: “Involvement of the central nervous system (CNS) by tuberculosis is rare; it can affect either immunocompromised or immunocompetent people.” The researchers focused on a case report to examine the issue further.

Results: The team studied a “case of tuberculosis with CNS involvement.” The patient was “an immunocompetent young man who developed fever, subacute headache, disturbance of consciousness, paraparesis, sphincter dysfunction, and hypoesthesia.” He was diagnosed with tuberculous meningitis, myeloradiculitis, and arachnoiditis. Based on the results, the authors concluded that “Methods for detection of CNS TB and treatment protocols should be constantly re-evaluated to improve treatment outcome and reduce likelihood and severity of neurological sequelae.”

//Clinical Trials

Effects of Vaporized Marijuana on Neuropathic Pain

Study Type: Interventional

Age/Gender Requirements: 18-70 years (male/female)

Sponsor: University of California, Davis

Purpose: The study is designed to “measure the pain-relieving effects of vaporized marijuana in subjects with neuropathic pain.” The researchers will also analyze “pain relief with mood, cognitive impairment, and psychomotor performance” to help evaluate the “utility of vaporized marijuana in a neuropathic pain population.”

Pregabalin for the Treatment of Central Neuropathic Pain

Study Type: Interventional

Age/Gender Requirements: 18 years (male/female)

Sponsor: Pfizer

Purpose: The study is designed “to assess the safety of the long-term use of pregabalin at doses up to 600 mg/day in patients with central neuropathic pain (post spinal cord injury pain, post stroke pain, and multiple sclerosis pain).”

From the HCPLIve Network

Drug Pumps Provide Relief for Some

Drug pumps may help to better control symptoms and reduce requirements for oral medications, according the North American Neuromodulation Society and the American Society of Interventional Pain Physicians.

Argument on Spinal Procedures to be Resolved

Researchers from Rush University Medical Center will be comparing minimally invasive surgery and open surgery to relieve back pain. The researchers will look for changes in complication rate, recovery time, outcome, and cost between the two procedures.

Pharma focus

Medrol (Methylprednisolone)

Clinical Trials

Study to Evaluate Intravenous and Oral Steroids for Multiple Sclerosis Attacks

Study Type: interventional

Age/Gender Requirements: 18-50 years (male/female)

Sponsor: Mount Sinai School of Medicine

Purpose: The study will compare “the relative efficacy of treating acute exacerbations of relapsing forms of Multiple Sclerosis with equivalent doses of oral and intravenous (IV) methylprednisolone.”

Greater Occipital Nerve Block for Migraine Prophylaxis

Study Type: Interventional

Age/Gender Requirements: 18-75 years (male/female)

Sponsor: Mayo Clinic

Purpose: “The purpose of this study is to determine whether greater occipital nerve block injection reduces the frequency of migraine headaches.”