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Foix-Alajouanine Syndrome Differential Diagnoses

  • Author: Cheryl Ann Palmer, MD; Chief Editor: Helmi L Lutsep, MD  more...
Updated: Aug 09, 2016

Diagnostic Considerations

In its early stages, Foix-Alajouanine syndrome may mimic a polyradiculopathy or anterior horn cell disorder. By the time upper motor neurons or sacral segments are involved, making it obvious that Foix-Alajouanine syndrome is present, a patient may already have substantial neurologic deficits.[5] Patients sometimes undergo unsuccessful lumbar disk prolapse surgery.[5] An incorrect diagnosis of spinal cord tumor may result from patient presentation and imaging examinations.

Conditions to consider in the differential diagnosis of Foix-Alajouanine syndrome include the following:

  • Lumbosacral disk syndromes
  • Cervical disk syndromes
  • Lumbosacral spondylosis
  • Polyradiculopathy
  • Primary or metastatic neoplastic disease
  • Spinal arachnoiditis
  • Spinal artery thrombosis
  • Spinal injury
  • Hereditary spastic paraplegias
  • HIV infection
  • HTLV-1 infection
  • Lyme disease (late disseminated infection)
  • Syphilis

Differential Diagnoses

Contributor Information and Disclosures

Cheryl Ann Palmer, MD Professor of Pathology, Director of Neuropathology, Director of Pathology Residency Program, Department of Pathology, Huntsman Cancer Institute, University of Utah School of Medicine

Cheryl Ann Palmer, MD is a member of the following medical societies: American Academy of Neurology, American Association of Neuropathologists, Society for Neuro-Oncology, International Society of Neuropathology

Disclosure: Nothing to disclose.


Meghan J Driscoll, MD Resident Physician, Department of Pathology, University of Utah School of Medicine

Meghan J Driscoll, MD is a member of the following medical societies: College of American Pathologists, Academy of Clinical Laboratory Physicians and Scientists, Society for Pediatric Pathology, Wyoming Public Health Association

Disclosure: Nothing to disclose.

Chief Editor

Helmi L Lutsep, MD Professor and Vice Chair, Department of Neurology, Oregon Health and Science University School of Medicine; Associate Director, OHSU Stroke Center

Helmi L Lutsep, MD is a member of the following medical societies: American Academy of Neurology, American Stroke Association

Disclosure: Medscape Neurology Editorial Advisory Board for: Stroke Adjudication Committee, CREST2.


Howard S Kirshner, MD Professor of Neurology, Psychiatry and Hearing and Speech Sciences, Vice Chairman, Department of Neurology, Vanderbilt University School of Medicine; Director, Vanderbilt Stroke Center; Program Director, Stroke Service, Vanderbilt Stallworth Rehabilitation Hospital; Consulting Staff, Department of Neurology, Nashville Veterans Affairs Medical Center

Howard S Kirshner, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Neurology, American Heart Association, American Medical Association, American Neurological Association, American Society of Neurorehabilitation, National Stroke Association, Phi Beta Kappa, and Tennessee Medical Association

Disclosure: BMS/Sanofi Honoraria Speaking and teaching

Francisco Talavera, PharmD, PhD, Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Reference Salary Employment

Richard M Zweifler, MD Chief of Neurology, Sentara Healthcare, Norfolk, VA; Professor of Neurology, Eastern Virginia Medical School, Norfolk, VA

Richard M Zweifler, MD is a member of the following medical societies: American Academy of Neurology, American Heart Association, American Medical Association, American Stroke Association, Royal Society of Medicine, and Stroke Council of the American Heart Association

Disclosure: Nothing to disclose.

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Gross photograph of the dorsal surface of the spinal cord showing dilated and tortuous vessels.
Photomicrograph of the cervical spinal cord region showing a thickened subarachnoid vein with a thrombotic occlusion (hematoxylin and eosin stain).
Photograph of the cervical spinal cord illustrating dilated, abundant subarachnoid veins (hematoxylin and eosin stain).
Photomicrograph of the cervical spinal cord region demonstrating several dilated, hyalinized intraparenchymal vessels (hematoxylin and eosin stain).
Photomicrograph of the cervical spinal cord depicting ischemic necrosis of the parenchyma (hematoxylin and eosin stain).
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