Intermittent Claudication of the Spinal Cord versus Neurogenic Claudication: Jean Jules Dejerine (1849–1917)

Abstract

Low back pain and its different clinical varieties of presentation continue to be a very prevalent disease in the general population. Lumbar spinal stenosis affects about 50% of the population over 60 years of age and neurogenic claudication is described among its clinical characteristics. The classic description of neurogenic claudication is often attributed to Jean Jules Dejerine in 1911. However, this description corresponds to another symptomatology and disease. In his classic presentation, he describes intermittent claudication of the spinal cord as a spinal cord syndrome associated with spasmodic (spastic) paraplegia. He first presents the clinical case of a 37-year-old patient who consulted for having a sensation of weight and sudden weakness in the left leg that appears only after walking a certain distance. The osteotendinous reflexes are increased, the plantar response is extensor (Babinski and Oppenheim positive) and is accompanied by alteration in the urinary and fecal sphincters (retention). Dejerine describes that the cause of intermittent claudication of the spinal cord is syphilitic myelitis. The aim of this paper is to present a historical review of the classic Dejerine study and to differentiate the description made in his article (Intermittent Claudication of the Spinal Cord) from the one that is currently clinically associated with lumbar spinal stenosis.