December 2017 Edition. Volume XVII

In 1926 French neurologist Charles Foix and his associate Alajouanine published their classic paper(1) on subacute necrotizing myelitis producing paralysis.  Theirs was the first description of what we now call adhesive arachnoiditis.  The etiology of this devastating condition was recurrent hemorrhage, into the subarachnoid space, from congenital arterio-venous malformations of the spinal cord.  The repeated bleeding led to scarring (adhesive arachnoiditis) and associated vascular thrombosis.  The end of this process was a necrotizing myelopathy producing paraplegia.  On April 25, 1947 Rudolph Jaeger of Jefferson University in Philadelphia first presented to the Philadelphia Neurological Society his experimental work studying the effect of iodized oils on the subarachnoid space of dogs(2).  In addition to observing that “ethyl iophendylate is extremely toxic” he found that the addition of blood, or blood products, greatly enhanced the inflammatory reaction.  Given the fact that there has been so little objective study ever performed on these important issues most physicians, and their patients, have learned little from the literature and have not, from studying history, been able to prevent it from repeating itself.

(1).  Foix C, Alajouanine T: La myelite necrotique subaigue: Myelite centrale angio-hypertrophe à evolution progressive, paraplegie amyotrophique lentement ascendante, d’abord spasmodique, puis Hasque, s’accompagnant de dissociation albuminocytologique. Rev. Neurol., 2:1-42, 1926.


(2).  Jaeger R: Irritating Effect of Iodized Vegetable Oils on the Brain and Spinal Cord when Divided into Small Particles. Arch. Neurol. & Psychiat. 64:715-719, 1950.

 

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