Acute Transverse Myelitis Caused by Herpes simplex Virus

Dr. med. Stephan Bamborschke, PD, Klinik und Poliklinik für Neurologie der Universität zu Köln, Joseph-Stelzmann-Strasse 9, D-50924 Köln (Germany) Case Report A 42-year-old man presented with dysesthesia and palsy of the right upper limb and developed a complete tetraplegia with sensory loss below the level of C6, bowel and bladder dysfunction within 10 days. There was no stiffness of the neck or disturbance of consciousness. The tendon reflexes were first absent and then became hyperactive. Babinski's sign was found on the right side. No herpetic cutaneous or genital lesions were found. On the basis of the PCR results (see below) the patient was treated with dexamethasone 24 mg/day i.v. and acyclovir 750 mg 3 times a day i.v. Within 10 weeks motor function of both legs and of the left arm recovered almost completely whereas the right arm remained mildly paretic. Bowel and bladder function were normal. A sensory disturbance below the level of TH8 remained.