Inoue et al.,2 found some interesting symptoms that were related to cauda equina tumor in the very earliest stage of the condition before the onset of recumbent night pain. In athletic patients they noticed a complaint of alternating bilateral sciatica that was synchronized with each stride during jogging. A careful history is necessary because the alternating sciatica did not create a severe pain. Except for jogging the patients were free of pain in daily activities. They found this symptom in six of eight patients with eventual cauda equina or lumbosacral cord tumor. Only one of 33 athletes with just lumbar disc herniations ever remembered this type of symptom.
The authors2 explained that the alternating sciatica was caused by a mobile tumor in the intradural space that accompanied up and down acceleration and deceleration during jogging. Jogging created radicular pain by causing alternating pressure on the nerve roots. One patient experienced right leg pain when his body tilted to the right and left leg pain when his body tilted to the left. They felt that the relief of night pain by sitting was a symptom in the late stage of the disease, at which time the tumor had become immobile. The alternating bilateral sciatica on jogging was seen only in athletic patients.
- Constans JP, DeDivitiis E, Donzelli R, et al. Spinal metastases with neurological manifestations. J Neurosurg 59;1983:111-118.
- Inoue K, Hukuda S, Katsuura A, Saruhashi Y. Alternating sciatica while jogging, an early symptom of cauda equina tumor. Clin Orth & Rel Res 328, 1996:102-107.
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