The reliability of LERI's sign in L4 and L3 radiculalgia.

Although not as frequent as sciatica, cruralgia remains one of the most frequent reasons why people consult a neurosurgeon. It should be kept in mind, however, that every anterior leg pain is not cruralgia and thus several diagnoses must be discarded, such as of musculoskeletal diseases of hip, pelvis and femur. In the last years of the 19th century, André Léri, a French neurologist, described Leri's sign as it is used widely even today in everyday clinical practice. We studied retrospectively files of those patients who were seen in Neurosurgery by the authors for L3 and L4 nerve root compression to evaluate the reliability and accuracy of this sign. Between October 1998 and September 2017, 38,654 patients were examined in our department of Neurosurgery. Among them, 1698 patients presented pain as cruralgia and meralgia. In total, 1545 patients were included in the study. The data analysis showed that the sensitivity of LS was 0.9333 and the specificity 0.7974. The results of the study show a reliable diagnostic accuracy of Leri's sign.

Co-occurrence of MS and ALS: a clue in favor of common pathophysiological findings?

Amyotrophic lateral sclerosis (ALS) and multiple sclerosis (MS) are two neurological disorders that seem, theoretically, completely divergent according to epidemiological, clinical, pathophysiological, and therapeutic data. However, some reports that have mentioned the occurrence of both conditions within the same patient underpin the suggestion that this co-occurrence might not be random. We report six co-occurrences of ALS and MS cases, focusing on epidemiological and clinical diseases findings. We then compare our cohort to those in the literature. Our cohort was composed of five females and one male. The age of onset for MS ranged from 27 to 54 years with either primary or secondary prominence while all being progressive. Both diseases occurred sequentially in all but one the cases. Concerning ALS, the age of onset ranged from 51 to 60 years and the site of onset was the legs in 5/6 cases. The disease lasted from four to 29 months. Although infrequent, this co-occurrence supports the hypothesis of common, pathophysiological mechanisms between ALS and MS. We discuss some arguments favoring a potential link between both conditions.