Foot-drop: an unusual complaint in Henoch-Schönlein purpura

Acute bilateral isolated foot drop: Report of two cases

Foot drop is defined as the weakness of the foot and ankle dorsiflexion. Acute unilateral foot drop is a well-documented entity, whereas bilateral foot drop is rarely documented. Slowly progressing bilateral foot drop may occur with various metabolic causes, parasagittal intracranial pathologies, and cauda equina syndrome. Acute onset of bilateral foot drop due to disc herniation is extremely rare. Here we present two cases of acute bilateral foot drop due to disc herniation. The first patient was a 45-year-old man presented with acute bilateral foot drop, without any sign of the cauda equina syndrome. Lumbar magnetic resonance imaging of the patient revealed L4-5 disc herniation. To our knowledge, this is the first presented case of acute bilateral foot drop without any signs of cauda equina syndrome caused by L4-5 disc herniation. The second patient was a 50-year-old man who was also presented with acute bilateral foot drop, and had T12-L1 disc herniation with intradural extension. Also this is the first presented case of T12-L1 disc herniation with intradural extension causing acute bilateral foot drop. We performed emergent decompressive laminectomy to both of the patients and extrude disc materials were excised. Both of the patients were recovered with favorable outcome.

Bilateral Footdrop After Treatment of an Anterior Communicating Artery Aneurysm: A Case Report and Review of the Literature

Background And Importance:

Footdrop designates weakness of the ankle as well as toes dorsiflexion. Peripheral causes of unilateral footdrop are well established. Bilateral footdrop originating from pathologies in the central nervous system are rare and include a number of unexplored etiologies.

Clinical Presentation:

A case of bilateral footdrop is presented. The patient presented with a grade IV subarachnoid hemorrhage with intraventricular extension. He was treated with coil embolization of an anterior communicating artery aneurysm. Postoperatively, he was found to have weakness of both ankle and toe dorsiflexion. Findings on magnetic resonance imaging of the cervical, thoracic, and lumbar spine were negative for abnormal cord signal, cord infarction, and compressive lesion. Magnetic resonance imaging of the brain revealed parasagittal bifrontal and right greater than left convexity foci of acute infarction.

Conclusion:

Central causes of acute footdrop are rare. However, they should be considered in the differential diagnosis, particularly in the presence of upper motor neuron signs on physical examination.