Cauda equina syndrome caused by lumbosacral epidural lipomatosis. A case report

Epidural lipomatosis with cauda equina syndrome in chronic alcoholic patient: A case report

“…Epidural fat is soft and vulnerable; however, SEL is characterized by abnormal accumulation of unencapsulated fat in the epidural space, which can cause a compressive CES [5], [9]. In previous case reports, SEL was induced in most patients by steroids, obesity, or idiopathic causes [10], [11].…”

“…CES with lipomatosis often lasts for months to several years, followed by progressive or sudden neurological deficits [5], [9], [20]. In some patients, it may be difficult to distinguish CES from a conus medullaris syndrome, which is usually symmetric, spares leg function, and has a sudden onset [5]. In this case, the clinical signs at onset were indicative of bilateral lower cauda equina dysfunction, suggesting a more diffuse involvement, consistent with the final diagnosis of lumbosacral epidural lipomatosis.…”

“…If neurological deficits develop, it is usually in the thoracic spine more than in the lumbar spine [1], [4]. Spinal epidural lipomatosis (SEL) with cauda equina syndrome (CES) is not a common clinical condition [5], [6]. Madelung disease (benign symmetrical lipomatosis) is diffuse deposits of fat arranged symmetrically in upper extremities, around the neck and shoulders.…”

Scoliosis associated with idiopathic lumbosacral epidural lipomatosis

“…SEL has been regarded as a consequence of longterm administration of exogenous excess steroids, local corticosteroid injections and endocrinopathy associated with a variety of glucocorticoid-producing systemic diseases that included Cushing's syndrome, obesity, carcinoid tumor, and hypothyroidism (1,2,4,5). Quite rarely, SEL occurs as an idiopathic condition that means in the absence of recognized predisposing factors (5).…”