A 14-year-old boy was referred with a complaint of seizure. There was paresthesia in both legs. The initial diagnosis was meningitis and a lumbar puncture was performed. Analysis of CSF was within normal limits. MRI showed fusion of the filum terminale, imitating tethered cord (figure 1). Cerebral MRI was normal. Control MRI revealed normal lumbar findings (figure 2). Lumbar puncture–induced intracranial hypotension has been reported,1 but the findings illustrated here of the filum terminale after lumbar puncture are unusual. Because the appearance may mimic tethered cord syndrome, additional imaging may help prevent misdiagnosis.
(A–E) Initial MRI shows a conjugation of the filum terminale (arrows) and reduced CSF space.
(A–E) Repeat MRI scan 10 days after the initial study shows normal filum terminale and conus medullaris.
Footnotes
Author contributions: Dr. Ogul and Dr. Genc: analysis and interpretation. Dr. Kantarci: critical revision of the manuscript for important intellectual content.
Study funding: No targeted funding reported.
Disclosure: The authors report no disclosures relevant to the manuscript. Go to Neurology.org for full disclosures.
- © 2014 American Academy of Neurology
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