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:
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Lumbosacral disk syndromes
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Cervical disk syndromes
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Lumbosacral spondylosis
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Polyradiculopathy
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Primary or metastatic neoplastic disease
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Spinal arachnoiditis
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Spinal artery thrombosis
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Spinal injury
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Hereditary spastic paraplegias
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HIV infection
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HTLV-1 infection
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Lyme disease (late disseminated infection)
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Syphilis
Differential Diagnoses
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Gross photograph of the dorsal surface of the spinal cord showing dilated and tortuous vessels.
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Photomicrograph of the cervical spinal cord region showing a thickened subarachnoid vein with a thrombotic occlusion (hematoxylin and eosin stain).
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Photograph of the cervical spinal cord illustrating dilated, abundant subarachnoid veins (hematoxylin and eosin stain).
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Photomicrograph of the cervical spinal cord region demonstrating several dilated, hyalinized intraparenchymal vessels (hematoxylin and eosin stain).
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Photomicrograph of the cervical spinal cord depicting ischemic necrosis of the parenchyma (hematoxylin and eosin stain).