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Recovery of gait after radiotherapy in paralytic patients with metastatic epidural spinal cord compression

From the Departments of Neurology (Drs. Helweg-Larsen and Sçrensen) and Oncology (Dr. Rasmusson), Rigshospitalet, Copenhagen, Denmark.

We report on 15 patients with paralysis of the legs caused by metastatic epidural spinal cord compression. After radiation therapy 6 patients regained motor function, 5 of whom recovered ambulatory function, but the recovery was delayed for 3 months or more. The duration of the paralysis prior to treatment varied from 20 hours to 10 days with no significant difference between the group with and the group without recovery. The median time from the initial motor symptoms to total paralysis was longer (45 days) in the patients who recovered compared with those permanently paralyzed (9 days). The response to radiation therapy seems to depend on the rate of loss of spinal cord function rather than the length of total paralysis. We recommend active treatment of patients with paraplegia due to metastatic epidural spinal cord compression, even when the paralysis has been present for over a week.

Address correspondence and reprint requests to Dr. Susanne Helweg-Larsen, Department of Neurology, Rigshospitalet, Blegdamsvej 9, Copenhagen 2100, Denmark.

Received November 3, 1989. Accepted for publication in final form January 17, 1990.

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