Paraparesis due to ischemic lumbosacral Radiculoplexopathy

Abstract

Background: Lumbosacral radiculoplexopathy (LSRP) is a rare entity, with several etiologies described in the literature. Vascular lesions to the lower part of the aorta and the common iliac artery can cause LSRP of ischemic etiology. Clinical Presentation: A 66-year-old man with a previous history of peripheral obstructive arterial disease (POAD) requiring aortobifemoral and femoropopliteal procedures had a prolonged hospital stay due to various complications: stent infection and occlusion, aortoenteric fistula causing hemorrhagic shock, transmetatarsal amputation of the right foot. In this context, he underwent multiple endovascular procedures. At discharge, the patient presented flaccid paraparesis, distal bilateral hypoesthesia, saddle anesthesia and urinary and anal incontinence. Spinal cord infarction was excluded. An electromyographic study confirmed the diagnosis of bilateral LSRP of ischemic etiology. Conclusion: This case highlights the importance of including ischemic etiology as a differential diagnosis of peripheral nerve injuries, namely in patients with POAD.