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A brief case series of radiation associated myelopathy
Sena D Bünül1, Cansu E Sarıkaya1, Onural Öztürk1
1From the Department of Neurology (Bünül, Sarıkaya), Faculty of Medicine, Kocaeli University, Kocaeli, from the Department of Neurosurgery (Sarıkaya), University of Health Sciences Istanbul Umraniye Training and Research Hospital, and from Seka State Hospital (Öztürk), Kocaeli, Turkey.
Abstract:
Radiation myelopathy (RM) is a rare but serious complication of radiotherapy. Small vessel ischemia and demyelination are some of the more remarkable indications of RM's pathophysiology. The RM is a diagnosis of exclusion. In the differential diagnosis, infectious causes, tumors, rheumatic diseases, and paraneoplastic syndromes are the main diseases that should be excluded. Contrast-enhanced magnetic resonance imaging (MRI) is a useful method for diagnosis. We present a report on 3 patients diagnosed with radiation myelitis. All the patients presented with late paraparasia and paresthesia. Despite high-dose steroids, hyperbaric oxygen, and physical therapy, there was no clinical improvement at the follow-up one year later.
Insights
Radiation myelopathy (RM) is a rare complication of radiotherapy. This study found no clinical improvement in patients with radiation myelitis despite aggressive treatment, highlighting the condition's severity.
Area of Science:
- Neurology
- Radiotherapy
- Oncology
Background:
- Radiation myelopathy (RM) is a rare but severe complication following radiotherapy.
- Pathophysiology involves small vessel ischemia and demyelination.
- RM is a diagnosis of exclusion, requiring differentiation from infectious, neoplastic, rheumatic, and paraneoplastic causes.
Purpose of the Study:
- To report on three patients diagnosed with radiation myelitis.
- To illustrate the clinical presentation and diagnostic challenges of RM.
Main Methods:
- Case report of three patients with radiation myelitis.
- Diagnosis confirmed via contrast-enhanced magnetic resonance imaging (MRI).
- Clinical outcomes assessed one year post-treatment.
Main Results:
- All patients presented with late-onset paraparesis and paresthesia.
- Standard treatments including high-dose steroids, hyperbaric oxygen, and physical therapy yielded no clinical improvement.
- Lack of response observed at one-year follow-up.
Conclusions:
- Radiation myelitis presents with significant neurological deficits.
- Current treatment modalities show limited efficacy in improving outcomes for radiation myelitis.
- Further research into novel therapeutic strategies for RM is warranted.
