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Abstract Details

Ischaemic Lumbrosacral Plexopathy following Infrarenal Aortic Thrombosis
General Neurology
P1 - Poster Session 1 (9:00 AM-5:00 PM)
170
Ischaemic lumbosacral plexopathy is a rare cause of plexopathy which can occur after vascular compromise to the lumbosacral plexus. We present the case of a patient with acute onset ischaemic lumbosacral plexopathy secondary to a thrombus of the infra-renal abdominal aorta.
A 59-year-old woman presented with acute onset asymmetrical, lower limb weakness with associated pain and numbness. Past medical history included psoriasis, previous alcohol excess and migraine. Examination was normal in the upper limbs but power was reduced in the lower limbs, with weakness more pronounced in the right leg. Ankle jerks were reduced bilaterally and the sensory examination revealed reduced sensation in the L4/L5 dermatomal distribution.
n/a
Initial electromyography (EMG) studies were within normal limits, but CK was raised at 21,142 U/L. Two months later, repeat EMG showed a mixed axonal neuropathy of the lower limbs with evidence of distal denervation. An extensive thrombus within the infrarenal abdominal aorta was found on CT Angiogram. Muscle biopsy of the left quadriceps muscle showed necrosis, inflammation and regeneration. Sural nerve biopsy revealed severe large fibre loss in a panfascicular distribution.

Ischaemic lumbosacral plexopathy should be considered in patients presenting with lower limb weakness and pain. Ischaemic lumbosacral plexopathy secondary to aorto-iliac occlusion is rare, with only three case reports in the literature. This is the first case report where ischaemic lumbosacral plexopathy secondary to aortic thrombotic occlusion has been confirmed histopathologically.
Authors/Disclosures
Suzanne K. Quigley, MB, BCh, BAO (Hons)
PRESENTER 		Dr. Quigley has nothing to disclose.
Emma Troy, MBBS Dr. Troy has nothing to disclose.
No disclosure on file
Aisling Ryan, PhD, MB, FRCPI Dr. Ryan has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck. Dr. Ryan has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen.