Date of Presentation
5-6-2021 12:00 AM
College
School of Osteopathic Medicine
Poster Abstract
Spinal Epidural Lipomatosis (SEL) an excess of normal adipose tissue in the epidural space of the spinal canal, typically becoming symptomatic when cord compression results. First described in 1975 by Lee et al (Lee M, 1975), it is a relatively rare disease. Unfortunately, it is often diagnosed once patients have developed marked symptoms and can have dire complications. Oftentimes SEL is completely asymptomatic, and symptoms on initial presentation are vague. Mostly commonly it presents as worsening chronic back pain (Daniel R. Fassett M.D. M.B.A., 2004) with progressive lower extremity weakness and occasional cauda equina syndrome (Wells AJ, 2014), but this is of course dependent on the level of the culprit lesions. What is unique about this case as compared to other instances of SLE, is that it presented as a stroke mimic. Ultimately little is known about the pathogenesis of this disease process, but generally SEL can be attributed to the following: exogenous steroids, excess endogenous steroid production from endocrine abnormalities, obesity, postsurgical changes, and idiopathic disease (Daniel R. Fassett M.D. M.B.A., 2004). With back pain being one of the most commonly encountered chief complaints in the ED, SEL proves itself as an example as to the importance of broad differentials.
Keywords
neoplasms, lipoma, Spinal Epidural Lipomatosis, back pain, stroke mimic
Disciplines
Medicine and Health Sciences | Neoplasms | Nervous System | Nervous System Diseases
Document Type
Poster
A Case of Spinal Epidural Lipomatosis Presenting as a Stroke Mimic
Spinal Epidural Lipomatosis (SEL) an excess of normal adipose tissue in the epidural space of the spinal canal, typically becoming symptomatic when cord compression results. First described in 1975 by Lee et al (Lee M, 1975), it is a relatively rare disease. Unfortunately, it is often diagnosed once patients have developed marked symptoms and can have dire complications. Oftentimes SEL is completely asymptomatic, and symptoms on initial presentation are vague. Mostly commonly it presents as worsening chronic back pain (Daniel R. Fassett M.D. M.B.A., 2004) with progressive lower extremity weakness and occasional cauda equina syndrome (Wells AJ, 2014), but this is of course dependent on the level of the culprit lesions. What is unique about this case as compared to other instances of SLE, is that it presented as a stroke mimic. Ultimately little is known about the pathogenesis of this disease process, but generally SEL can be attributed to the following: exogenous steroids, excess endogenous steroid production from endocrine abnormalities, obesity, postsurgical changes, and idiopathic disease (Daniel R. Fassett M.D. M.B.A., 2004). With back pain being one of the most commonly encountered chief complaints in the ED, SEL proves itself as an example as to the importance of broad differentials.