Idiopathic Chronic Adhesive Arachnoiditis Presenting with Paraparesis

Arachnoiditis is a heterogeneous, relatively complex, and challenging process for an inflammatory response involving the arachnoid mater. Major symptoms include chronic, sometimes incapacitating pain, neurological deficit, and finally, some degree of disturbance of normal flow of cerebrospinal fluid. Diagnosis depends on all these factors: history of the patient, examination of the patient, and sophisticated imaging techniques like magnetic resonance imaging (MRI). Treatment is essentially supportive, consisting of pain management and improvement in function, which may need a multimodal approach of medications, physical therapy, and surgical interventions. The authors present this case report of a 45-year-old female patient treated for chronic paraparesis due to dense arachnoid adhesions entrapping nerve roots that required surgical intervention. Her symptoms began 4 years ago and have progressed; this underlines the fact that an earlier diagnosis with a tailored care plan could have made a difference. MRI imaging was significant in the identification of characteristic radiological markers of arachnoiditis. In the postoperative rehabilitation plan, physiotherapy was included to attain better functional status. Although motor recovery remained limited, decompression of the affected nerve roots provided symptomatic relief. For any comprehensive care strategies in chronic arachnoiditis, a multidisciplinary approach with health providers from all specialties is necessary. Continuous follow-up and individual rehabilitation programs form the mainstay of optimizing recovery and managing long-term symptoms.