Epidural lipomatosis
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Epidural lipomatosis is an unusual condition. It is most often associated with Cushing syndrome and exogenous corticosteroid drug therapy. Patients with rheumatoid arthritis, systemic lupus erythematosus, asthma, and dermatomyositis as well as transplant recipients have all been reported to develop epidural lipomatosis after undergoing steroid therapy. Long-term steroid treatment is usually required to exacerbate lipomatosis. It usually occurs in thoracic or lumbar spine. Although results of neurologic examination may be normal, patients with epidural lipomatosis usually present with weakness, decreased sensation and reflexes, and mild back pain. Alterations in bowel and bladder function are seen infrequently. The treatment of epidural lipomatosis often consists of reduction in steroid dose and prescribed weight loss. Patients who undergo surgery for decompression may have a mortality rate (up to 22%), probably due to the overall immunosuppressed status of affected patients.
On T1-weighted images, the high signal intensity of prominent epidural fat is generally diagnostic for epidural lipomatosis.
