Abstract Details

Title Post Radiation Lower Motor Neuron Syndrome - Case Series and Literature Review

Topic Neuro-oncology

Presentation(s) P01 - (-)

Poster/Presentation
Number 106

Objective

Background A variety of neurological syndromes has been described after irradiation of the distal spinal cord and cauda equina, mainly due to testicular cancer and lymphoma. One of these syndromes is a rare lower motor neuron syndrome, manifested by flaccid paraparesis.

Design/Methods Medical files of patients with post radiation lower motor neuron syndrome treated in our neuromuscular clinic from 2005 to 2012 were reviewed. The diagnosis was based on past irradiation of the distal spinal cord and cauda equina, slowly progressive lower limb weakness, characteristic electrophysiological studies, and no alternative diagnosis. In addition, a systematic review of the literature on similar cases was performed using PUBMED.

Results We identified five patients with post radiation lower motor neuron syndrome in our clinic charts. Three of them were irradiated due to seminoma, and the other two due to lymphoma. 45 additional similar cases were found in a literature search, mainly male (89%), with testicular cancer (67%), irradiated at mean age of 33 years, with an average irradiation dose of 5225 cGy (range 3000-14600), and a latency period between irradiation and symptoms onset ranging from 3 months to 27 years (average 9 years). Magnetic resonance imaging was done only in few, showing gadolinium enhancement of the cauda equina in close to half of them (7/16).

Conclusions Our patients and those previously described in the literature form a distinct clinical and electrophysiological syndrome that might be more frequent then previously expected, and should be not overlooked.

Authors/Disclosures
Alon Abraham, MD (Tel Aviv Sourasky Medical Center) PRESENTER	No disclosure on file
Alex Rovira	Alex Rovira has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Alex Rovira has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sanofy. Alex Rovira has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. Alex Rovira has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Alex Rovira has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Alex Rovira has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. Alex Rovira has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Alex Rovira has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Alex Rovira has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Biogen. Alex Rovira has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. Alex Rovira has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bristol Myers. Alex Rovira has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bayer. Alex Rovira has stock in Tensor Medical.
Vivian E. Drory, MD (Tel-Aviv Medical Center)	Prof. Drory has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Teva. Prof. Drory has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Amylyx. Prof. Drory has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Takeda. Prof. Drory has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Argenx. Prof. Drory has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Medison Pharma. The institution of Prof. Drory has received research support from Neurosense Therapeutics. The institution of Prof. Drory has received research support from AB Science. The institution of Prof. Drory has received research support from Biogen. The institution of Prof. Drory has received research support from Neuralight.

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