Foix-Alajouanine Syndrome Clinical Presentation

Updated: Oct 04, 2018
  • Author: Cheryl Ann Palmer, MD; Chief Editor: Helmi L Lutsep, MD  more...
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Presentation

History

Patients present with increasing unilateral and/or bilateral weakness, dysesthesias, and numbness or tingling in the lower extremities, which may be symmetrical or asymmetrical. [6] Early problems with bowel, bladder, and sexual function are common. [7]

After brief exertion, symptoms begin as a heavy feeling in the legs that generally improves with rest. The symptoms gradually worsen over months, and the patient may have difficulty standing for long periods. Frequent falls can be a problem. Urinary and fecal incontinence eventually occur.

Complaints of nonradiating lower back pain in the lumbosacral or coccygeal regions are common. This may initially be interpreted as sciatica. Weakness or numbness eventually can progress to the upper extremities.

In most patients, Foix-Alajouanine syndrome follows a protracted course over a few years before a diagnosis is made. [5] In a minority of patients, however, an acute onset of symptoms is reported.

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Physical Examination

A physical examination can reveal the following:

  • Neurologic examination - Reveals an alert patient with normal mentation

  • Mental status, speech, language, and cranial nerve function - Generally are normal

  • Unsteadiness of gait - Common; may be halting in nature but on a narrow base

  • Spastic or flaccid paraparesis and a sensory level below the lesion

  • Deep tendon reflexes - May be normal or increased

  • Bilateral Babinski signs - May be present, as may clonus; upper motor neuron and lower motor neuron signs may be seen simultaneously [5]

  • Vibration and joint position senses - Usually are preserved

  • Rectal sphincter tone - Frequently is diminished

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