Premium
Occult chronic progressive cervical and thoracic myelopathy without evident magnetic resonance imaging lesion
Author(s) -
Nomura Emi,
Yamashita Toru,
Takahashi Yoshiaki,
Tsunoda Keiichiro,
Shang Jingwei,
Sato Kota,
Takemoto Mami,
Hishikawa Nozomi,
Ohta Yasuyuki,
Ueno Hiroki,
Abe Koji
Publication year - 2017
Publication title -
neurology and clinical neuroscience
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.125
0ISSN - 2049-4173
DOI - 10.1111/ncn3.12136
Subject(s) - medicine , magnetic resonance imaging , myelopathy , occult , pathology , lesion , radiology , spinal cord , alternative medicine , psychiatry
Progressive myelopathy is caused by infectious, inflammatory, autoimmune, paraneoplastic, demyelinating, vascular, hereditary, degenerative, metabolic and toxic properties. Here, we report a case of a 53‐year‐old woman who showed a progressive cervical and thoracic myelopathy with muscle weakness in all limbs, and hypoesthesia in all limbs and trunk below the Th8 level without any evident magnetic resonance imaging lesions. She displayed rheumatoid factor, anti‐double stranded DNA antibody and hepatitis B surface antigen, as well as an elevated cerebrospinal fluid protein level. The paraneoplastic antibodies that we examined were negative. Our treatments (plasma exchange, steroid pulse therapy and immunoglobulin therapy) were slightly effective, but the symptoms did not improve completely. The present case suggests that the presence of a cervical and thoracic lesion without evident magnetic resonance imaging abnormalities required a careful follow up to discover occult lesions.