Which physical findings are characteristic of spinal epidural abscess?

Updated: Jul 12, 2018
  • Author: J Stephen Huff, MD, FACEP; Chief Editor: Niranjan N Singh, MBBS, MD, DM, FAHS, FAANEM  more...
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See the list below:

  • In some patients, fever is found at presentation.

  • Physical findings vary with the degree of spinal cord compression or dysfunction.

  • In the most advanced cases, a transverse cord syndrome is seen with motor and sensory levels found with neurologic examination.

  • Localized tenderness to percussion or palpation at the site of the abscess may be noted. Paraspinal muscle spasm may be present.

  • Signs of spinal cord dysfunction may be observed.

    • Complete transverse spinal cord syndrome with paraplegia and sphincter dysfunction

    • Incomplete spinal cord syndromes

    • Unilateral motor or sensory deficits [10]

    • Gait ataxia [10]

  • Reflexes may vary from absent to hyperreflexia with clonus and extensor plantar (Babinski) responses. Areflexia may indicate spinal shock with transient inhibition of spinal reflexes.

  • Nuchal stiffness or rigidity may be present, notably with cervical epidural abscesses.

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