Mystery Case: Widespread plexiform neurofibromas in neurofibromatosis type 1: An uncommon cause of back pain

A 23-year-old man with known neurofibromatosis type 1 (NF1) presented with low back pain described as a "wringing" sensation, with radiation to both legs and painful spasms upon awakening. Examination was significant for reduced reflexes bilaterally. The figure is a coronal T2-weighted MRI revealing extensive plexiform neurofibromas arising from all lumbosacral nerve roots. Neurofibromas appear as high signal intensity on T2-weighted images due to increased fluid in myelin associated with dysplastic glial proliferation.1 In patients with NF1 presenting with back pain or polyradiculopathy, imaging should be obtained to evaluate for neurofibroma-mediated spinal cord pathology.
Source: Neurology - Category: Neurology Authors: Tags: MRI, Peripheral neuropathy, Nerve tumor, Neuropathic pain, Neurofibromatosis RESIDENT AND FELLOW SECTION Source Type: research