Tarlov Cysts Masquerading as Peripheral Neuropathy

Abstract

A 43-YEAR-OLD WOMAN presentedwithparesthesiaandnumbness in her right foot. Three months later, the same symptoms appeared in her left footandhergait startedtobecome unsteady.Shehadoccasionallowback pain without any radicular pain or bladder symptoms. She was referred totheUniversityofChicagoNeuropathyCenter,Chicago, Ill,afterbeingdiagnosedwithperipheralneuropathy. Examination showed weakness of some of the right distal foot muscles. Vibratory sensation was mildly decreased at the toes; the pinprick and light touch sensations were diminished in the distal legs and feet, to a greater extent on the right. Ankle and knee reflexes were normal. Electromyography showed a chronic right lumbar radiculopathy and no neuropathy. Lumbar spine magnetic resonance imaging (Figure 1) and post–computed tomography myelographic scan (Figure 2) showed multilevel, bilateral, sacral Tarlov cysts. Thepatient’s symptomsimproved partially after injection of tissue adhesive into the lower sacral cysts. COMMENT