RESEARCH
ARTICLE

This thesis was added
14 July 2002

The Presenting Symptoms Associated With Arachnoiditis And The Experience Of Living With Them In Everyday Life

A thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Nursing at Massey University

by Christine Hopkins - 1998

Glossary

arachnoid cysts - arachnoid cysts are outpouchings of the arachnoid lining. They are usually considered to be idiopathic and possibly congenital. If they compress the spinal cord, the cauda equina or individual nerve roots, they can be associated with pain, sensory changes, urinary dysfunction and weakness. The intensity of these symptoms can alter dramatically with postural changes.

arachnoiditis - inflammation of the arachnoidea.

causalgia - disruption in normal flow of sensory information along nerve to brain creating confusion for the brain which is interpreted as a uniquely disabling pain state, constant and highly resistant to normal forms of medical therapy.

chronic adhesive arachnoiditis - thickening and adhesions of the leptomeninges in the brain and spinal cord, resulting from previous meningitis, other disease processes, or trauma; the signs and symptoms vary with the extent and location.

clonic spasm - rigidity of the muscles, followed immediately by relaxation.

cauda equina compression - most often due to neoplasm but also by lipoma, in spina bifida occulta, constricting fibrous band or by chronic arachnoiditis. If a complication of ankylosing spondylitis, it may also be due to arachnoiditis, but is more often associated with arachnoid cysts.

cramp - sustained spasm, or tetanic contraction of an entire muscle, which lasts for just a few seconds or several hours, causing the muscle to become taut and painful; among other causes, linked to irritability of the spinal cord.

fasciculation - a small local contraction of muscles, visible through the skin, representing a spontaneous discharge of a number of fibres innervated by a single motor nerve filament. In association with compression of the spinal cord, ventral roots or anterior horns of grey matter, fasciculation of the muscles innervated by the affected segments will occur, along with progressive wasting and weakness.

focal arachnoiditis – arachnoiditis focused on a small area of damage in the spine

myelomalacia - morbid softening of the spinal cord. Associated with tuberculosis of the spine and with paralysis.

myoclonus - shocklike contractions of a portion of a muscle or an entire muscle or a group of muscles. The term ‘myoclonus’ is applied to a brief, shock-like muscular contraction which may be confined to a single muscle or may involve many muscles, either successively or simultaneously. Often, contractions may occur symmetrically in muscles on the opposite sides of the body. The contraction may be too slight to cause movement or can cause such violent movement as to throw the person to the ground. The contraction does not affect groups of muscles which are normally synergistically associated, nor does it usually affect mutually antagonistic muscles.

neuralgia - paroxysmal pain which extends along the course of one or more nerves. Many varieties are distinguished according to the part affected or the cause.

neurogenic - originating in the nervous system

neurogenic claudication - syndrome associated with a narrow spinal canal. Typically, there is a distinctly unpleasant sensation in the legs, which can be frankly painful in some cases. It is variably described as numb, cold, burning or cramping and characteristically appears after assumption of an upright posture or during prolonged extension of the lumbar spine. May begin in the feet and spread proximally or vice versa. Paraesthesias often appear when the person is standing still, but typically are brought on by walking. These points help to distinguish it from peripheral vascular claudication in which cramps affect the legs after exercise regardless of posture. A useful rule of thumb is that the patient whose intermittent claudication is due to arterial insufficiency would rather walk downhill than uphill. The reverse is true of the person with a narrow spinal canal since the back is slightly flexed in climbing.

neuropathic - pertaining to or characterised by neuropathy..

neuropathy - a general term denoting functional disturbances and/or pathological changes in the peripheral nervous system. The aetiology may be known eg diabetic neuropathy, ischemic neuropathy, traumatic neuropathy or unknown. Encephalopathy and myelopathy are corresponding terms relating to involvement of the brain and spinal cord, respectively. The term is also used to designate non-inflammatory lesions in the peripheral nervous system.

radicular - of or pertaining to a root

radiculitis - inflammation of the root of a spinal nerve, especially that portion of the root which lies between the spinal cord and the intervertebral canal

remitting, remittent - having periods of abatement and exacerbation without actual cessation of the symptoms.

silent arachnoiditis - scarring process in spine before later development of symptoms different to initial symptoms

spasm - a sudden involuntary muscle twitch attended by pain ranging in severity from merely irritating to very painful and interfering with function, producing involuntary movement and distortion

spasticity - a form of increased tone or hypertonia resulting from lesions of the pyramidal and often of the reticulospinal pathway, the stretch reflexes, released from descending inhibitor influences, become hyperactive as a consequence of increased excitability of dynamic fusimotor neurones and alpha neurones. If the dorsal reticulospinal system, closely related anatomically to the pyramidal tract in the spinal cord, is also damaged, there is disinhibition of afferent flexor reflex pathways. Release of such flexor reflexes may give flexor spasms in the lower limbs in response to stimulation of the legs, or the bladder or bowel.