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Inflammatory hypertrophic cauda equina following intrathecal neural stem cell injection
Author(s) -
Hurst Richard W.,
Peter Bosch E.,
Morris Jonathan M.,
Dyck P. James B.,
Reeves Ronald K.
Publication year - 2013
Publication title -
muscle and nerve
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.025
H-Index - 145
eISSN - 1097-4598
pISSN - 0148-639X
DOI - 10.1002/mus.23920
Subject(s) - cauda equina , medicine , intrathecal , neural stem cell , cauda equina syndrome , stem cell , pathology , anesthesia , spinal cord , surgery , biology , microbiology and biotechnology , psychiatry
: Potential benefit from stem cell treatments has more patients seeking treatment without understanding possible risks. Methods : We describe a woman who presented with progressive bilateral leg pain, numbness, and gait difficulties. A prior stroke, macular degeneration, osteoarthritis, and depression, led her to receive intrathecal neural stem cell therapy overseas 1 year before onset of symptoms. Results : Imaging showed marked enlargement of lumbosacral roots of the cauda equina, which was not seen before stem cell treatment. Electrodiagnostic studies confirmed chronic multiple lumbosacral radiculopathies. Biopsy of a lumbar dorsal sensory root showed myelinated fiber degeneration and loss, with endoneurial inflammation. The hypertrophic inflammatory cauda equina syndrome was potentially triggered by the prior intrathecal neural stem cell injection. Conclusions : Safety of intrathecal stem cell treatments is not routinely regulated in overseas stem cell facilities. We wish to bring this potential complication to the attention of health care providers. Muscle Nerve 48:831–835, 2013