NOMENCLATURE

Arachnoiditis is chronic inflammation of the arachnoid layer of the meninges. (The spinal meninges are in 3 layers, dura, arachnoid and pia.)

The arachnoid layer of the meninges is part of the leptomeninges, the pia being the other. It may therefore also be known as chronic leptomeningitis. Other terms include arachnoiditis adhesiva circumscripta, and arachnitis.

Arachnoiditis may be present in anyone who has had spinal injury, surgery or introduction of foreign substances, but in most people it causes no problems. The most common form is arachnoid adhesions.

The second type is local arachnoiditis, which generally results from some local insult to the subarachnoid space, such as injury or surgery. Again, it may not cause symptoms.

The most severe type, which may be progressive and more likely to cause symptoms, is adhesive arachnoiditis. It may be mild, moderate or severe, and either focal (localised) or diffuse. The latter type tends to result from insults involving introduction of foreign substances into the subarachnoid space. (See causes)

Table of Contents

Introduction
THE SCALE OF THE PROBLEM
ARACHNOIDITIS OR EPIDURAL FIBROSIS?
NOMENCLATURE
NEXT: THE INFLAMMATORY NATURE OF ADHESIVE ARACHNOIDITIS
PATHOLOGY
CLASSIFICATION
CAUSES
THE IATROGENIC ASPECT OF ADHESIVE ARACHNOIDITIS
PRESERVATIVES IN SPINAL INJECTIONS
PROGNOSIS
THE SYNDROMIC NATURE OF SYMPTOMS IN ADHESIVE ARACHNOIDITIS (Warning: LONG)
COMPLICATIONS OF ADHESIVE ARACHNOIDITIS
DIFFERENTIAL DIAGNOSIS
CLINICAL ASSESSMENT
DIAGNOSTIC TESTS
TREATMENT OPTIONS (Warning: LONG)
MULTIPLE CHEMICAL SENSITIVITY
LOOKING TO THE FUTURE
APPENDIX I: AUTOIMMUNE ASPECTS
APPENDIX II: SYRINGOMYELIA
ADDENDUM - May 2000
REFERENCES