====== Elsberg syndrome ======

Elsberg syndrome is a rare but well-defined clinical condition, including acute or subacute lumbosacral meningoradiculitis, which might be accompanied by myelitis and is often associated with herpes simplex virus type 2 (HSV-2) infection. We report the case of an immunocompetent 24-year-old man who presented with perineal pain, saddle hypoesthesia, and urinary retention associated with Elsberg syndrome due to HSV-2 infection 20-day after the posterior lumbar spinal fusion surgery. Lumbar magnetic resonance imaging (MRI) with gadolinium enhancement showed mildly enhanced and swollen right sacral nerve roots. One week after the admission, [[electromyography]] and nerve conduction studies (EMG-NCS) demonstrated severe axonal damage and [[radiculopathy]] at right S3 and S4 roots. Cerebrospinal fluid (CSF) analysis revealed lymphocytic pleocytosis, elevated protein, positive HSV-2 IgG index, and positive HSV-2 polymerase chain reaction (PCR). The patient was treated with intravenous acyclovir for 14 days and showed a gradual improvement in anal sphincter control and urination. Therefore, according to our findings, surgery might have an immunosuppressing role, and in cases with symptoms of [[cauda equina syndrome]] (CES) and systemic infection, in the postoperative setting, viral meningoradiculitis should be considered
((Tavanaei R, Oraee-Yazdani M, Allameh F, Eliaspour D, Zali AR, Oraee-Yazdani S. Cauda equina syndrome due to herpes simplex virus type 2-associated meningoradiculitis (Elsberg syndrome) after posterior lumbar spinal fusion surgery: Case report and review of literature. Clin Neurol Neurosurg. 2021 Apr 1;205:106624. doi: 10.1016/j.clineuro.2021.106624. Epub ahead of print. PMID: 33887503.)).