Elsberg Syndrome – Under-Recognition of HSV-2 Lumbosacral Radiculitis among Canadians
Bibliographic record
Abstract
Elsberg syndrome is an underrecognized entity characterized by urinary retention, sacral radiculitis, and cerebrospinal fluid pleocytosis, associated with either an acute infection or herpes-simplex 2 virus (HSV-2) reactivation. With HSV-2 prevalence among Canadians averaging 10-15%, awareness of atypical presentations and potential complications is critical for clinicians. Early recognition and treatment may help improve patient outcomes and decrease neurologic disease morbidity, including neuropathic pain, chronic urinary retention, and paraplegia. Here, we report a case of Elsberg syndrome in a 56-year-old female with no known history of prior HSV-2 infection who presented with sacral radiculitis, myelitis, urinary retention, and a positive cerebrospinal fluid HSV-2 PCR. We use this case to illustrate the key clinical, diagnostic, and radiographic features clinicians should be familiar with in clinical practice. Elsberg syndrome is an uncommon but significant neurological manifestation of HSV-2, and improved recognition of Elsberg syndrome may lead to more timely diagnosis, treatment, and improved neurologic outcomes.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.003 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".