Foix-Alajouanine Syndrome Clinical Presentation
- Author: Cheryl Ann Palmer, MD; Chief Editor: Helmi L Lutsep, MD more...
Patients present with increasing unilateral and/or bilateral weakness, dysesthesias, and numbness or tingling in the lower extremities, which may be symmetrical or asymmetrical. Early problems with bowel, bladder, and sexual function are common.
After brief exertion, symptoms begin as a heavy feeling in the legs that generally improves with rest. The symptoms gradually worsen over months, and the patient may have difficulty standing for long periods. Frequent falls can be a problem. Urinary and fecal incontinence eventually occur.
Complaints of nonradiating lower back pain in the lumbosacral or coccygeal regions are common. This may initially be interpreted as sciatica. Weakness or numbness eventually can progress to the upper extremities.
In most patients, Foix-Alajouanine syndrome follows a protracted course over a few years before a diagnosis is made. In a minority of patients, however, an acute onset of symptoms is reported.
A physical examination can reveal the following:
Neurologic examination - Reveals an alert patient with normal mentation
Mental status, speech, language, and cranial nerve function - Generally are normal
Unsteadiness of gait - Common; may be halting in nature but on a narrow base
Spastic or flaccid paraparesis and a sensory level below the lesion
Deep tendon reflexes - May be normal or increased
Bilateral Babinski signs - May be present, as may clonus; upper motor neuron and lower motor neuron signs may be seen simultaneously 
Vibration and joint position senses - Usually are preserved
Rectal sphincter tone - Frequently is diminished
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