[Corticosteroid-induced epidural lipomatosis. Efficacy of medical treatment]

We describe a further case of cauda equina compression secondary to steroid-induced epidural lipomatosis in a patient treated for IBD. The diagnosis was rapidly confirmed by MRI allowing conservative management by corticosteroid withdrawal as well as use of hygiene and dietary measures. Therapeutic efficacy was noted on a clinical basis and confirmed by repeated follow-up MRI exams which showed regression of fat accumulation. Symptomatic epidural lipomatosis is probably underestimated because physicians concerned by steroid treatment are not fully informed about this potentially severe and usually iatrogenic disease. Also, proper medical attention to the first neurological symptom in these patients might help limit therapeutic management to a medical measurer, before requiring surgical decompressive surgery.