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Foix-Alajouanine Syndrome Medication

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

Medication Summary

With few exceptions, pharmacologic intervention is used only for symptomatic treatment of Foix-Alajouanine syndrome. Agents used in this therapy include the following:

  • Corticosteroids - Dexamethasone
  • Anticoagulants - Heparin
  • Antibiotics - Including amoxicillin and trimethoprim-sulfamethoxazole (TMP-SMZ); for bowel and bladder infections and terminal sepsis


Class Summary

Anti-inflammatory medications may improve neurologic disability during acute symptoms.

Dexamethasone (Baycadron)


Dexamethasone is a synthetic adrenocortical steroid. During the acute phase of Foix-Alajouanine syndrome, intravenous (IV) dexamethasone may improve neurologic disability.


Anticoagulants, Hematologic

Class Summary

If angiographic evidence of thrombosis exists, anticoagulation with heparin may be indicated.



Heparin inhibits reactions that lead to blood clotting and the formation of fibrin clots (in vitro and in vivo). The drug is administered intravenously; oral administration is not effective. Adjust the dosage according to the patient's coagulation test results. The dosage is considered adequate when the activated partial thromboplastin time (aPTT) is 1.5-2 times normal. Continue heparin administration for at least 48 hours after the therapeutic value of aPTT has been reached.


Antibiotics, Other

Class Summary

Institute proper antibiotic therapy as indicated for bladder or bowel infections and for terminal sepsis, which frequently has a pulmonary etiology.

Amoxicillin (Moxatag)


Amoxicillin is an analogue of ampicillin with broad-spectrum bactericidal activity against many gram-positive and gram-negative organisms.

Trimethoprim-sulfamethoxazole (Bactrim, Bactrim DS, Septra DS)


TMP-SMZ is a synthetic, broad-spectrum antibacterial combination that inhibits bacterial synthesis of dihydrofolic acid by competing with para-aminobenzoic acid, resulting in the inhibition of bacterial growth.

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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