Elsberg syndrome - A systematic review of existing scientific literature from 2000 - 2023

Objective: To assess the clinical presentation, causative agents, and treatment outcomes in patients diagnosed with Elsberg syndrome (ES).

Methods: A thorough literature search was conducted on the mentioned topic using PRISMA guidelines via PubMed, Google Scholar, and SCOPUS. Articles published between 2000 and 2023 were included using advanced search and Boolean strategy. A total of 19 case reports were included in the systematic review according to set criteria and after quality assessment.

Results: The average age at presentation was 48.9 ± 18.9 years, with a male majority of 57.9%. Lower limb sensory deficit followed by bladder dysfunction were the two most common presenting symptoms in 52.63% and 47.37% patients, respectively. Sensory loss and vesicular rash were the most frequently found signs at presentation in 36.84% and 26.32% patients, respectively. Varicella zoster virus (VZV) and herpes simplex virus (HSV) were the most common infectious agents found equivocally in 36.84% cases each. Complete resolution with definitive treatment was seen in 84.21% of patients. The average follow-up duration was 5.16 months.

Conclusion: ES should be considered as a differential in patients with a prior or recent history of HSV or VZV infection who present with signs and symptoms of acute lumbosacral myeloradiculopathy. Combination therapy with antimicrobials and corticosteroids has shown promising results targeting both the infectious and inflammatory aspects of the disease.