Intradural Disc Herniation Presenting with Acute Onset Bilateral Isolated Foot Drop

Abstract

Intradural disc herniation is a rare entity that occurs most frequently in the lumbar spine. Most often it is diagnosed intraoperatively. Acute onset of bilateral foot drop due to intradural disc herniation without any sign of the cauda equina syndrome is also extremely rare. We described a case of a 41-year-old male who presented to us with acute onset bilateral foot drop without any sign of the cauda equina syndrome. He had previously been diagnosed as having multiple- level intervertebral herniations and managed conservatively. He was admitted to the emergency room with acute onset bilateral foot drop. Lumbar MRI revealed multiple-level disc herniations and extruded disc fragment at L2-L3 level. L2 and L3 laminectomies were performed and a hard intradural mass was palpable. On opening the dura a fragment of intervertebral disc was found with a small defect in the anterior dura. The fragment was removed and the dura was sutured. The patient recovered well from the surgery. Intradural disc herniation must be considered in the differential diagnosis of acute onset bilateral foot drop without any sign of the cauda equina syndrome.