Qadri Haseeb Mehmood, Pervaiz Salman, Ijaz Momin, Fatir Chaudhary Abdul, Anwar Muhammad Usama, Babar Muhammad Saad, Bashir Asif
Dr. Haseeb Mehmood Qadri, MBBS, Punjab Institute of Neurosciences, Lahore, Punjab, Pakistan.
Dr. Salman Pervaiz, MBBS. The Ohio State University/Wexner Medical Center, Columbus, Ohio, United States of America.
Pak J Med Sci. 2024 Dec;40(12PINS Suppl):S103-S113. doi: 10.12669/pjms.40.12(PINS).11105.
To assess the clinical presentation, causative agents, and treatment outcomes in patients diagnosed with Elsberg syndrome (ES).
A thorough literature search was conducted on the mentioned topic using PRISMA guidelines via PubMed, Google Scholar, and SCOPUS. Articles published between 2000 and 2023 were included using advanced search and Boolean strategy. A total of 19 case reports were included in the systematic review according to set criteria and after quality assessment.
The average age at presentation was 48.9 ± 18.9 years, with a male majority of 57.9%. Lower limb sensory deficit followed by bladder dysfunction were the two most common presenting symptoms in 52.63% and 47.37% patients, respectively. Sensory loss and vesicular rash were the most frequently found signs at presentation in 36.84% and 26.32% patients, respectively. Varicella zoster virus (VZV) and herpes simplex virus (HSV) were the most common infectious agents found equivocally in 36.84% cases each. Complete resolution with definitive treatment was seen in 84.21% of patients. The average follow-up duration was 5.16 months.
ES should be considered as a differential in patients with a prior or recent history of HSV or VZV infection who present with signs and symptoms of acute lumbosacral myeloradiculopathy. Combination therapy with antimicrobials and corticosteroids has shown promising results targeting both the infectious and inflammatory aspects of the disease.
评估诊断为埃尔斯伯格综合征(ES)患者的临床表现、病原体及治疗结果。
按照PRISMA指南,通过PubMed、谷歌学术和SCOPUS对上述主题进行全面的文献检索。使用高级搜索和布尔策略纳入2000年至2023年发表的文章。根据既定标准并经质量评估后,系统评价共纳入19例病例报告。
发病时的平均年龄为48.9±18.9岁,男性占多数,为57.9%。下肢感觉障碍和膀胱功能障碍是最常见的两种症状,分别见于52.63%和47.37%的患者。感觉丧失和水疱性皮疹是发病时最常见的体征,分别见于36.84%和26.32%的患者。水痘带状疱疹病毒(VZV)和单纯疱疹病毒(HSV)是最常见的病原体,各在36.84%的病例中被明确发现。84.21%的患者经确定性治疗后完全缓解。平均随访时间为5.16个月。
对于有HSV或VZV感染既往史或近期感染史且出现急性腰骶部脊髓神经根病体征和症状的患者,应考虑ES的鉴别诊断。抗菌药物和皮质类固醇的联合治疗在针对该疾病的感染和炎症方面均显示出有前景的结果。