ABSTRACT
Low back and neck pain, with or without radiculopathy, are one of the most common
reasons for referral to an outpatient neurology practice. Determining appropriate
treatment relies on establishing an accurate diagnosis of the etiology of the spine
or limb pain. The author reviews structural radiculopathies as a result of diskogenic
and spondylotic etiologies with an emphasis on the clinical approach and evaluation
of these patients (including imaging and electrodiagnostics), identifying management
altering neurogenic mimickers of structural radiculopathies (such as infectious, inflammatory,
and neoplastic myeloradiculitis and radiculoplexopathies), and stratifying patients
for treatment.
KEYWORDS
Radiculopathy - low back pain - neck pain - electromyography - nerve conduction studies
- radiculopathy mimickers
REFERENCES
- 1
Martin B I, Deyo R A, Mirza S K et al..
Expenditures and health status among adults with back and neck problems.
JAMA.
2008;
299
(6)
656-664
- 2
Deyo R A, Weinstein J N.
Low back pain.
N Engl J Med.
2001;
344
(5)
363-370
- 3
Deyo R A, Mirza S K, Martin B I.
Back pain prevalence and visit rates: estimates from U.S. national surveys, 2002.
Spine (Phila Pa 1976).
2006;
31
(23)
2724-2727
- 4
Côté P, Cassidy J D, Carroll L J, Kristman V.
The annual incidence and course of neck pain in the general population: a population-based
cohort study.
Pain.
2004;
112
(3)
267-273
- 5
Jarvik J G, Hollingworth W, Heagerty P J et al..
Three-year incidence of low back pain in an initially asymptomatic cohort: clinical
and imaging risk factors.
Spine (Phila Pa 1976).
2005;
30
(13)
1541-1548
discussion 1549
- 6
Kelsey J L, White 3rd A A.
Epidemiology and impact of low-back pain.
Spine (Phila Pa 1976).
1980;
5
(2)
133-142
- 7
Argoff C A, Wheeler A H.
Spinal and radicular pain disorders.
Neurol Clin.
1998;
16
(4)
833-850
- 8
Cohen S P, Argoff C E, Carragee E J.
Management of low back pain.
BMJ.
2008;
337
a2718
- 9
Luo X, Pietrobon R, Sun S X, Liu G G, Hey L.
Estimates and patterns of direct health care expenditures among individuals with back
pain in the United States. Spine.
(Phila Pa 1976).
2004;
29
(1)
79-86
- 10
Martin B I, Turner J A, Mirza S K et al..
Trends in health care expenditures, utilization, and health status among US adults
with spine problems, 1997–2006.
Spine (Phila Pa 1976).
2009;
34
(19)
2077-2084
- 11
Friedly J, Chan L, Deyo R.
Increases in lumbosacral injections in the Medicare population: 1994 to 2001.
Spine (Phila Pa 1976).
2007;
32
(16)
1754-1760
- 12
Deyo R A, Gray D T, Kreuter W, Mirza S, Martin B I.
United States trends in lumbar fusion surgery for degenerative conditions.
Spine (Phila Pa 1976).
2005;
30
(12)
1441-1445
discussion 1446-1447
- 13
Wang M C, Kreuter W, Wolfla C E, Maiman D J, Deyo R A.
Trends and variations in cervical spine surgery in the United States: Medicare beneficiaries,
1992 to 2005.
Spine (Phila Pa 1976).
2009;
34
(9)
955-961
discussion 962-953
- 14
Gray D T, Deyo R A, Kreuter W et al..
Population-based trends in volumes and rates of ambulatory lumbar spine surgery.
Spine (Phila Pa 1976).
2006;
31
(17)
1957-1963
discussion 1964
- 15
Deyo R A, Mirza S K, Martin B I, Kreuter W, Goodman D C, Jarvik J G.
Trends, major medical complications, and charges associated with surgery for lumbar
spinal stenosis in older adults.
JAMA.
2010;
303
(13)
1259-1265
- 16
Deyo R A, Mirza S K.
Trends and variations in the use of spine surgery.
Clin Orthop Relat Res.
2006;
443
139-146
- 17
Weiner D K, Kim Y S, Bonino P, Wang T.
Low back pain in older adults: are we utilizing healthcare resources wisely?.
Pain Med.
2006;
7
(2)
143-150
- 18
Boswell M V, Trescot A M, Datta S American Society of Interventional Pain Physicians
et al.
Interventional techniques: evidence-based practice guidelines in the management of
chronic spinal pain.
Pain Physician.
2007;
10
(1)
7-111
- 19
Chou R, Atlas S J, Stanos S P, Rosenquist R W.
Nonsurgical interventional therapies for low back pain: a review of the evidence for
an American Pain Society clinical practice guideline.
Spine (Phila Pa 1976).
2009;
34
(10)
1078-1093
- 20
Chou R, Baisden J, Carragee E J et al..
Surgery for low back pain: a review of the evidence for an American Pain Society Clinical
Practice Guideline.
Spine (Phila Pa 1976).
2009;
34
(10)
1094-1109
- 21
Weinstein J N, Tosteson T D, Lurie J D et al..
Surgical vs nonoperative treatment for lumbar disk herniation: the Spine Patient Outcomes
Research Trial (SPORT): a randomized trial.
JAMA.
2006;
296
(20)
2441-2450
- 22
Vroomen P C, de Krom M C, Wilmink J T, Kester A D, Knottnerus J A.
Diagnostic value of history and physical examination in patients suspected of lumbosacral
nerve root compression.
J Neurol Neurosurg Psychiatry.
2002;
72
(5)
630-634
- 23
Bouhassira D, Attal N, Fermanian J et al..
Development and validation of the Neuropathic Pain Symptom Inventory.
Pain.
2004;
108
(3)
248-257
- 24
Krause S J, Backonja M M.
Development of a neuropathic pain questionnaire.
Clin J Pain.
2003;
19
(5)
306-314
- 25
Galer B S, Jensen M P.
Development and preliminary validation of a pain measure specific to neuropathic pain:
the Neuropathic Pain Scale.
Neurology.
1997;
48
(2)
332-338
- 26
Bennett M.
The LANSS Pain Scale: the Leeds assessment of neuropathic symptoms and signs.
Pain.
2001;
92
(1-2)
147-157
- 27
Lauder T D.
Musculoskeletal disorders that frequently mimic radiculopathy.
Phys Med Rehabil Clin N Am.
2002;
13
(3)
469-485
- 28
Cannon D E, Dillingham T R, Miao H, Andary M T, Pezzin L E.
Musculoskeletal disorders in referrals for suspected lumbosacral radiculopathy.
Am J Phys Med Rehabil.
2007;
86
(12)
957-961
- 29
Cannon D E, Dillingham T R, Miao H, Andary M T, Pezzin L E.
Musculoskeletal disorders in referrals for suspected cervical radiculopathy.
Arch Phys Med Rehabil.
2007;
88
(10)
1256-1259
- 30
Tarulli A W, Raynor E M.
Lumbosacral radiculopathy.
Neurol Clin.
2007;
25
(2)
387-405
- 31
Fukui S, Ohseto K, Shiotani M, Ohno K, Karasawa H, Naganuma Y.
Distribution of referred pain from the lumbar zygapophyseal joints and dorsal rami.
Clin J Pain.
1997;
13
(4)
303-307
- 32
Chou R, Fu R, Carrino J A, Deyo R A.
Imaging strategies for low-back pain: systematic review and meta-analysis.
Lancet.
2009;
373
(9662)
463-472
- 33
Chou R, Qaseem A, Snow V Clinical Efficacy Assessment Subcommittee of the American
College of Physicians et al.
Diagnosis and treatment of low back pain: a joint clinical practice guideline from
the American College of Physicians and the American Pain Society.
Ann Intern Med.
2007;
147
(7)
478-491
- 34
van Tulder M, Becker A, Bekkering T COST B13 Working Group on Guidelines for the Management
of Acute Low Back Pain in Primary Care et al.
Chapter 3. European guidelines for the management of acute nonspecific low back pain
in primary care.
Eur Spine J.
2006;
15
(Suppl 2)
S169-S191
- 35 Bartleson J D, Deen H G. Spine Disorders. Medical and Surgical Management. New
York, NY: Cambridge University Press; 2009
- 36
Vroomen P C, de Krom M C, Knottnerus J A.
Consistency of history taking and physical examination in patients with suspected
lumbar nerve root involvement.
Spine (Phila Pa 1976).
2000;
25
(1)
91-96
discussion 97
- 37
Lauder T D, Dillingham T R, Andary M et al..
Effect of history and exam in predicting electrodiagnostic outcome among patients
with suspected lumbosacral radiculopathy.
Am J Phys Med Rehabil.
2000;
79
(1)
60-68
quiz 75-66
- 38 Wiebers D O, Dale A JD, Kokmen E, Swanson J W Eds.. Mayo Clinic Examinations in
Neurology. 7th ed. St. Louis, MO: Mosby; 1998
- 39
Vroomen P C, de Krom M C, Knottnerus J A.
Diagnostic value of history and physical examination in patients suspected of sciatica
due to disc herniation: a systematic review.
J Neurol.
1999;
246
(10)
899-906
- 40
Deville W L, van der Windt D A, Dzaferagic A, Bezemer P D, Bouter L M.
The test of Lasegue: systematic review of the accuracy in diagnosing herniated discs.
Spine (Phila Pa 1976).
2000;
25
(9)
1140-1147
- 41
Kosteljanetz M, Bang F, Schmidt-Olsen S.
The clinical significance of straight-leg raising (Lasegue's sign) in the diagnosis
of prolapsed lumbar disc. Interobserver variation and correlation with surgical finding.
Spine (Phila Pa 1976).
1988;
13
(4)
393-395
- 42
Kerr R S, Cadoux-Hudson T A, Adams C B.
The value of accurate clinical assessment in the surgical management of the lumbar
disc protrusion.
J Neurol Neurosurg Psychiatry.
1988;
51
(2)
169-173
- 43
Haswell K, Gilmour J, Moore B.
Clinical decision rules for identification of low back pain patients with neurologic
involvement in primary care.
Spine (Phila Pa 1976).
2008;
33
(1)
68-73
- 44
van den Hoogen H M, Koes B W, van Eijk J T, Bouter L M.
On the accuracy of history, physical examination, and erythrocyte sedimentation rate
in diagnosing low back pain in general practice. A criteria-based review of the literature.
Spine (Phila Pa 1976).
1995;
20
(3)
318-327
- 45
Rabin A, Gerszten P C, Karausky P, Bunker C H, Potter D M, Welch W C.
The sensitivity of the seated straight-leg raise test compared with the supine straight-leg
raise test in patients presenting with magnetic resonance imaging evidence of lumbar
nerve root compression.
Arch Phys Med Rehabil.
2007;
88
(7)
840-843
- 46
Gilbert K K, Brismee J M, Collins D L et al..
2006 Young Investigator Award Winner: lumbosacral nerve root displacement and strain:
part 2. A comparison of 2 straight leg raise conditions in unembalmed cadavers.
Spine (Phila Pa 1976).
2007;
32
(14)
1521-1525
- 47
Sanderson S P, Houten J, Errico T, Forshaw D, Bauman J, Cooper P R.
The unique characteristics of “upper” lumbar disc herniations.
Neurosurgery.
2004;
55
(2)
385-389
discussion 389
- 48
Nadler S F, Malanga G A, Stitik T P, Keswani R, Foye P M.
The crossed femoral nerve stretch test to improve diagnostic sensitivity for the high
lumbar radiculopathy: 2 case reports.
Arch Phys Med Rehabil.
2001;
82
(4)
522-523
- 49
van der Windt D A, Simons E, Riphagen I I et al..
Physical examination for lumbar radiculopathy due to disc herniation in patients with
low-back pain.
Cochrane Database Syst Rev.
2010;
2
(2)
CD007431
- 50
Radhakrishnan K, Litchy W J, O'Fallon W M, Kurland L T.
Epidemiology of cervical radiculopathy. A population-based study from Rochester, Minnesota,
1976 through 1990.
Brain.
1994;
117
(Pt 2)
325-335
- 51
Wainner R S, Fritz J M, Irrgang J J et al..
Reliability and diagnostic accuracy of the clinical examination and patient self-report
measures for cervical radiculopathy.
Spine (Phila Pa 1976).
2003;
28
(1)
52-62
- 52
Viikari-Juntura E, Porras M, Laasonen E M.
Validity of clinical tests in the diagnosis of root compression in cervical disc disease.
Spine (Phila Pa 1976).
1989;
14
(3)
253-257
- 53
Rubinstein S M, Pool J J, van Tulder M W, Riphagen I I, de Vet H C.
A systematic review of the diagnostic accuracy of provocative tests of the neck for
diagnosing cervical radiculopathy.
Eur Spine J.
2007;
16
(3)
307-319
- 54
Jensen M C, Brant-Zawadzki M N, Obuchowski N, Modic M T, Malkasian D, Ross J S.
Magnetic resonance imaging of the lumbar spine in people without back pain.
N Engl J Med.
1994;
331
(2)
69-73
- 55
Scavone J G, Latshaw R F, Rohrer G V.
Use of lumbar spine films. Statistical evaluation at a university teaching hospital.
JAMA.
1981;
246
(10)
1105-1108
- 56
Cheung K M, Karppinen J, Chan D et al..
Prevalence and pattern of lumbar magnetic resonance imaging changes in a population
study of one thousand forty-three individuals.
Spine (Phila Pa 1976).
2009;
34
(9)
934-940
- 57
Jönsson B, Strömqvist B.
Clinical appearance of contained and noncontained lumbar disc herniation.
J Spinal Disord.
1996;
9
(1)
32-38
- 58
Jensen T S, Albert H B, Soerensen J S, Manniche C, Leboeuf-Yde C.
Natural course of disc morphology in patients with sciatica: an MRI study using a
standardized qualitative classification system.
Spine (Phila Pa 1976).
2006;
31
(14)
1605-1612
discussion 1613
- 59
Ahn S H, Ahn M W, Byun W M.
Effect of the transligamentous extension of lumbar disc herniations on their regression
and the clinical outcome of sciatica.
Spine (Phila Pa 1976).
2000;
25
(4)
475-480
- 60
Komori H, Shinomiya K, Nakai O et al..
The natural history of herniated nucleus pulposus with radiculopathy.
Spine (Phila Pa 1976).
1996;
21
(2)
225-229
- 61
Bush K, Cowan N, Katz D E, Gishen P.
The natural history of sciatica associated with disc pathology. A prospective study
with clinical and independent radiologic follow-up.
Spine (Phila Pa 1976).
1992;
17
(10)
1205-1212
- 62
Matsubara Y, Kato F, Mimatsu K, Kajino G, Nakamura S, Nitta H.
Serial changes on MRI in lumbar disc herniations treated conservatively.
Neuroradiology.
1995;
37
(5)
378-383
- 63
Bozzao A, Gallucci M, Masciocchi C, Aprile I, Barile A, Passariello R.
Lumbar disk herniation: MR imaging assessment of natural history in patients treated
without surgery.
Radiology.
1992;
185
(1)
135-141
- 64
Haig A J, Tzeng H M, LeBreck D B.
The value of electrodiagnostic consultation for patients with upper extremity nerve
complaints: a prospective comparison with the history and physical examination.
Arch Phys Med Rehabil.
1999;
80
(10)
1273-1281
- 65
Levin K H.
L5 radiculopathy with reduced superficial peroneal sensory responses: intraspinal
and extraspinal causes.
Muscle Nerve.
1998;
21
(1)
3-7
- 66
Weber F, Albert U.
Electrodiagnostic examination of lumbosacral radiculopathies.
Electromyogr Clin Neurophysiol.
2000;
40
(4)
231-236
- 67
Nardin R A, Patel M R, Gudas T F, Rutkove S B, Raynor E M.
Electromyography and magnetic resonance imaging in the evaluation of radiculopathy.
Muscle Nerve.
1999;
22
(2)
151-155
- 68
Kuruoglu R, Oh S J, Thompson B.
Clinical and electromyographic correlations of lumbosacral radiculopathy.
Muscle Nerve.
1994;
17
(2)
250-251
- 69
Tonzola R F, Ackil A A, Shahani B T, Young R R.
Usefulness of electrophysiological studies in the diagnosis of lumbosacral root disease.
Ann Neurol.
1981;
9
(3)
305-308
- 70
Haldeman S, Shouka M, Robboy S.
Computed tomography, electrodiagnostic and clinical findings in chronic workers' compensation
patients with back and leg pain.
Spine (Phila Pa 1976).
1988;
13
(3)
345-350
- 71
Khatri B O, Baruah J, McQuillen M P.
Correlation of electromyography with computed tomography in evaluation of lower back
pain.
Arch Neurol.
1984;
41
(6)
594-597
- 72
Kendall R, Werner R A.
Interrater reliability of the needle examination in lumbosacral radiculopathy.
Muscle Nerve.
2006;
34
(2)
238-241
- 73
Berger A R, Busis N A, Logigian E L, Wierzbicka M, Shahani B T.
Cervical root stimulation in the diagnosis of radiculopathy.
Neurology.
1987;
37
(2)
329-332
- 74
Lauder T D, Dillingham T R, Andary M et al..
Predicting electrodiagnostic outcome in patients with upper limb symptoms: are the
history and physical examination helpful?.
Arch Phys Med Rehabil.
2000;
81
(4)
436-441
- 75
Chou R, Loeser J D, Owens D K et al..
Interventional therapies, surgery, and interdisciplinary rehabilitation for low back
pain: an evidence-based clinical practice guideline from the American Pain Society.
Spine (Phila Pa 1976).
2009;
34
(10)
1066-1077
- 76
Baron R, Freynhagen R, Tolle T R et al..
The efficacy and safety of pregabalin in the treatment of neuropathic pain associated
with chronic lumbosacral radiculopathy.
Pain.
2010;
150
(3)
420-427
- 77
Attal N, Cruccu G, Baron R et al..
EFNS guidelines on the pharmacological treatment of neuropathic pain: 2009 revision.
Eur J Neurol.
2010;
17
(9)
1113-e88
- 78
Dworkin R H, O'Connor A B, Backonja M et al..
Pharmacologic management of neuropathic pain: evidence-based recommendations.
Pain.
2007;
132
(3)
237-251
- 79
Dworkin R H, O'Connor A B, Audette J et al..
Recommendations for the pharmacological management of neuropathic pain: an overview
and literature update.
Mayo Clin Proc.
2010;
85
(3, Suppl)
S3-S14
- 80
Abdi S, Datta S, Trescot A M et al..
Epidural steroids in the management of chronic spinal pain: a systematic review.
Pain Physician.
2007;
10
(1)
185-212
- 81
Koes B W, Scholten R J, Mens J M, Bouter L M.
Efficacy of epidural steroid injections for low-back pain and sciatica: a systematic
review of randomized clinical trials.
Pain.
1995;
63
(3)
279-288
- 82
Armon C, Argoff C E, Samuels J, Backonja M M. Therapeutics and Technology Assessment
Subcommittee of the American Academy of Neurology .
Assessment: use of epidural steroid injections to treat radicular lumbosacral pain:
report of the Therapeutics and Technology Assessment Subcommittee of the American
Academy of Neurology.
Neurology.
2007;
68
(10)
723-729
- 83
Weinstein J N, Lurie J D, Tosteson T D et al..
Surgical vs nonoperative treatment for lumbar disk herniation: the Spine Patient Outcomes
Research Trial (SPORT) observational cohort.
JAMA.
2006;
296
(20)
2451-2459
- 84
Weber H.
Lumbar disc herniation. A controlled, prospective study with ten years of observation.
Spine (Phila Pa 1976).
1983;
8
(2)
131-140
- 85
Osterman H, Seitsalo S, Karppinen J, Malmivaara A.
Effectiveness of microdiscectomy for lumbar disc herniation: a randomized controlled
trial with 2 years of follow-up.
Spine (Phila Pa 1976).
2006;
31
(21)
2409-2414
- 86
Atlas S J, Keller R B, Wu Y A, Deyo R A, Singer D E.
Long-term outcomes of surgical and nonsurgical management of sciatica secondary to
a lumbar disc herniation: 10 year results from the Maine lumbar spine study.
Spine (Phila Pa 1976).
2005;
30
(8)
927-935
- 87
Parsonage M J, Turner J W.
Neuralgic amyotrophy; the shoulder-girdle syndrome.
Lancet.
1948;
1
(6513)
973-978
- 88
van Alfen N, van Engelen B G.
The clinical spectrum of neuralgic amyotrophy in 246 cases.
Brain.
2006;
129
(Pt 2)
438-450
- 89
England J D, Sumner A J.
Neuralgic amyotrophy: an increasingly diverse entity.
Muscle Nerve.
1987;
10
(1)
60-68
- 90
Sureka J, Cherian R A, Alexander M, Thomas B P.
MRI of brachial plexopathies.
Clin Radiol.
2009;
64
(2)
208-218
- 91
Scalf R E, Wenger D E, Frick M A, Mandrekar J N, Adkins M C.
MRI findings of 26 patients with Parsonage-Turner syndrome.
AJR Am J Roentgenol.
2007;
189
(1)
W39-44
- 92
Suarez G A, Giannini C, Bosch E P et al..
Immune brachial plexus neuropathy: suggestive evidence for an inflammatory-immune
pathogenesis.
Neurology.
1996;
46
(2)
559-561
- 93
Kuhlenbäumer G, Hannibal M C, Nelis E et al..
Mutations in SEPT9 cause hereditary neuralgic amyotrophy.
Nat Genet.
2005;
37
(10)
1044-1046
- 94
Dyck P J, Norell J E, Dyck P J.
Non-diabetic lumbosacral radiculoplexus neuropathy: natural history, outcome and comparison
with the diabetic variety.
Brain.
2001;
124
(Pt 6)
1197-1207
- 95
Dyck P J, Windebank A J.
Diabetic and nondiabetic lumbosacral radiculoplexus neuropathies: new insights into
pathophysiology and treatment.
Muscle Nerve.
2002;
25
(4)
477-491
- 96
Dyck P J, Norell J E, Dyck P J.
Methylprednisolone may improve lumbosacral radiculoplexus neuropathy.
Can J Neurol Sci.
2001;
28
(3)
224-227
- 97
Dyck P J, Norell J E, Dyck P J.
Microvasculitis and ischemia in diabetic lumbosacral radiculoplexus neuropathy.
Neurology.
1999;
53
(9)
2113-2121
- 98
Dyck P J.
Methylprednisolone may improve symptoms in diabetic lumbosacral radiculoplexus neuropathies.
Neurology.
2006;
66
A191
- 99
Jaeckle K A, Young D F, Foley K M.
The natural history of lumbosacral plexopathy in cancer.
Neurology.
1985;
35
(1)
8-15
- 100
Jaeckle K A.
Neurological manifestations of neoplastic and radiation-induced plexopathies.
Semin Neurol.
2004;
24
(4)
385-393
- 101
Jaeckle K A.
Nerve plexus metastases.
Neurol Clin.
1991;
9
(4)
857-866
- 102
Harper Jr C M, Thomas J E, Cascino T L, Litchy W J.
Distinction between neoplastic and radiation-induced brachial plexopathy, with emphasis
on the role of EMG.
Neurology.
1989;
39
(4)
502-506
- 103
Thomas J E, Cascino T L, Earle J D.
Differential diagnosis between radiation and tumor plexopathy of the pelvis.
Neurology.
1985;
35
(1)
1-7
- 104
Bowen B C, Verma A, Brandon A H, Fiedler J A.
Radiation-induced brachial plexopathy: MR and clinical findings.
AJNR Am J Neuroradiol.
1996;
17
(10)
1932-1936
- 105
Iaconetta G, Lamaida E, Rossi A, Signorelli F, Manto A, Giamundo A.
Leptomeningeal carcinomatosis: review of the literature.
Acta Neurol (Napoli).
1994;
16
(4)
214-220
- 106
Byrne T N.
Spinal cord compression from epidural metastases.
N Engl J Med.
1992;
327
(9)
614-619
- 107
Little J R, Dale A J, Okazaki H.
Meningeal carcinomatosis. Clinical manifestations.
Arch Neurol.
1974;
30
(2)
138-143
- 108
Pavlidis N.
The diagnostic and therapeutic management of leptomeningeal carcinomatosis.
Ann Oncol.
2004;
15
(Suppl 4)
285-291
- 109
Anders H J, Goebel F D.
Cytomegalovirus polyradiculopathy in patients with AIDS.
Clin Infect Dis.
1998;
27
(2)
345-352
- 110
So Y T, Olney R K.
Acute lumbosacral polyradiculopathy in acquired immunodeficiency syndrome: experience
in 23 patients.
Ann Neurol.
1994;
35
(1)
53-58
- 111
Jeha L E, Sila C A, Lederman R J, Prayson R A, Isada C M, Gordon S M.
West Nile virus infection: a new acute paralytic illness.
Neurology.
2003;
61
(1)
55-59
- 112
Sejvar J J, Haddad M B, Tierney B C et al..
Neurologic manifestations and outcome of West Nile virus infection.
JAMA.
2003;
290
(4)
511-515
- 113
Mahieux F, Gray F, Fenelon G et al..
Acute myeloradiculitis due to cytomegalovirus as the initial manifestation of AIDS.
J Neurol Neurosurg Psychiatry.
1989;
52
(2)
270-274
- 114
Kolson D L, Gonzalez-Scarano F.
HIV-associated neuropathies: role of HIV-1, CMV, and other viruses.
J Peripher Nerv Syst.
2001;
6
(1)
2-7
- 115
Gilden D H, Kleinschmidt-DeMasters B K, LaGuardia J J, Mahalingam R, Cohrs R J.
Neurologic complications of the reactivation of varicella-zoster virus.
N Engl J Med.
2000;
342
(9)
635-645
- 116
Gilden D, Cohrs R J, Mahalingam R, Nagel M A.
Varicella zoster virus vasculopathies: diverse clinical manifestations, laboratory
features, pathogenesis, and treatment.
Lancet Neurol.
2009;
8
(8)
731-740
- 117
Logigian E L.
Peripheral nervous system Lyme borreliosis.
Semin Neurol.
1997;
17
(1)
25-30
- 118
Logigian E L, Steere A C.
Clinical and electrophysiologic findings in chronic neuropathy of Lyme disease.
Neurology.
1992;
42
(2)
303-311
James WatsonM.D.
Departments of Neurology and Anesthesiology - Pain Division, Mayo Clinic
200 First Street SW, Rochester, MN 55905
eMail: watson.james@mayo.edu
