Acute central cord syndrome arising from a cervical epidural abscess: case report.

Abstract

Acute central cord syndrome (ACCS) is a well-known sequela to spinal trauma but has rarely been associated with nontraumatic etiologies. Spinal epidural abscess (SEA) and spinal osteomyelitis/discitis are also well characterized clinical entities. Neither SEA nor osteomyelitis leading to ACCS has been previously reported. In this report, a patient presented with refractory neck pain after minor trauma followed by development of left hand weakness and paresthesia, which progressed to a classic central cord injury clinical pattern over a period of 4 weeks. Imaging and laboratory studies were consistent with SEA and osteomyelitis. Motor evoked potentials obtained during surgery definitively corroborated the clinical diagnosis of ACCS and supported a long tract pathophysiology. ACCS may be caused by SEA.