A Case of Central Cord Syndrome Related Status Epilepticus - A Case Report -

Abstract

Central cord syndrome (CCS) is extremely rare as a direct consequence of generalized epileptic seizure. CCS is associated with hyperextension of the spinal cord and has characteristic radiologic findings including posterior ligamentous injury and prevertebral hyperintensity following magnetic resonance imaging (MRI). We experienced the case of a 25-year-old man who suffered CCS after status epilepticus. Cervical spinal MRI revealed high signal intensity at the C1 level but with no signal or structural changes in other sites. After rehabilitation management, the patient significantly improved on the ASIA (American Spinal Injury Association) motor scale and bladder function. We proposed that epilepsy related CCS may be caused by muscle contractions during generalized seizure, which can induce traction injury of the spinal cord or relative narrowing of spinal canal via transient herniated nucleus pulposus or transient subluxation of vertebra. We also suggest CCS without radiologic findings of trauma has good prognosis compared with other CCS.

Diagnosis and management of traumatic cervical central spinal cord injury: A review

“…noted that a 25-year-old male sustained a CCS after status epilepticus [ Table 2 ]. [ 18 ] Notably, the cervical MRI showed a hyperintense signal in the cord opposite the C1 level without other pathology; the patient, managed nonsurgically, improved on the AMS and regained bladder function. The CSS injury was attributed to muscle contractions occurring during generalized seizures.…”

Spinal cord injury and its underlying mechanism in rats with temporal lobe epilepsy

“…Several clinical cases of spinal cord injury following seizure have been reported (1)(2)(3), including those in primary (1) and secondary epilepsy (3). In grand mal epilepsy, impairments of the face and head commonly occur due to mechanical injury (4).…”

“…Thoracic and lumbar injury have also been reported and are considered to be caused by strong muscular contractions during seizures (2,3). However, there are some limitations to the mechanical injury hypothesis, as not all patients with spinal cord injury show evidence of trauma or other underlying lesions (1). Furthermore, the nature of the pathological changes following epilepsy-associated spinal cord injury are not fully understood.…”