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[Paraparesis due to gout].

A Ferreira1, B A Silva Júnior, F M Braga

  • 1Hospital Municipal Arthur Ribeiro de Saboya, São Paulo, Brasil.

Arquivos De Neuro-Psiquiatria
|December 1, 1989
PubMed
Summary

A young man with chronic gout developed leg weakness due to sodium urate deposits compressing his spinal cord. Surgical removal of these deposits did not restore function, highlighting challenges in managing spinal gout complications.

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Area of Science:

  • Rheumatology
  • Neurology
  • Spinal Surgery

Background:

  • Gout is a common inflammatory arthritis caused by monosodium urate crystal deposition.
  • Chronic tophaceous gout involves the formation of urate deposits (tophi) in various tissues.
  • Spinal canal involvement in gout is rare but can lead to significant neurological deficits.

Observation:

  • A 23-year-old male with a history of polyarthritis and chronic tophaceous gout presented with crural paraparesis.
  • Neurological examination revealed progressive weakness in both lower extremities.
  • Imaging studies confirmed the presence of sodium urate deposits within the spinal canal, causing compression.

Findings:

  • The patient underwent decompressive laminectomy and removal of urate-laden ligamentum flavum.

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  • Despite surgical intervention, there was no improvement in the patient's neurological function.
  • This case adds to the limited literature, with only nine previously reported instances of spinal tophaceous gout causing similar symptoms.

    • Implications:

    • This case underscores the potential for severe neurological complications in chronic tophaceous gout.
    • It highlights the limited efficacy of surgical decompression in established spinal cord compression by urate deposits.
    • Further research into early diagnosis and medical management strategies for spinal gout is warranted to prevent irreversible neurological damage.