Subacute transverse myelitis with Lyme profile dissociation
Introduction: Transverse myelitis is a very rare neurologic syndrome with an incidence per year of 1-5 per million population. We are presenting an interesting case of subacute transverse myelitis with its MRI (magnetic resonance imaging) and CSF (cerebrospinal fluid) findings. Case: A 46-year-old A...
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| Format: | Article |
| Language: | deu |
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German Medical Science GMS Publishing House
2008-06-01
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| Series: | GMS German Medical Science |
| Subjects: | |
| Online Access: | http://www.egms.de/en/gms/2008-6/000049.shtml |
| _version_ | 1811194582949429248 |
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| author | Ajjan, Mohammed Walid, M. Sami Ulm, Arthur J. |
| author_facet | Ajjan, Mohammed Walid, M. Sami Ulm, Arthur J. |
| author_sort | Ajjan, Mohammed |
| collection | DOAJ |
| description | Introduction: Transverse myelitis is a very rare neurologic syndrome with an incidence per year of 1-5 per million population. We are presenting an interesting case of subacute transverse myelitis with its MRI (magnetic resonance imaging) and CSF (cerebrospinal fluid) findings. Case: A 46-year-old African-American woman presented with decreased sensation in the lower extremities which started three weeks ago when she had a 36-hour episode of sore throat. She reported numbness up to the level just below the breasts. Lyme disease antibodies total IgG (immunoglobulin G) and IgM (immunoglobulin M) in the blood was positive. Antinuclear antibody profile was within normal limits. MRI of the cervical spine showed swelling in the lower cervical cord with contrast enhancement. Cerebrospinal fluid was clear with negative Borrelia Burgdorferi IgG and IgM. Herpes simplex, mycoplasma, coxiella, anaplasma, cryptococcus and hepatitis B were all negative. No oligoclonal bands were detected. Quick improvement ensued after she was given IV Ceftriaxone for 7 days. The patient was discharged on the 8th day in stable condition. She continued on doxycycline for 21 days. Conclusions: Transverse myelitis should be included in the differential diagnosis of any patient presenting with acute or subacute myelopathy in association with localized contrast enhancement in the spinal cord especially if flu-like prodromal symptoms were reported. Lyme disease serology is indicated in patients with neurological symptoms keeping in mind that dissociation in Lyme antibody titers between the blood and the CSF is possible. |
| first_indexed | 2024-04-12T00:29:38Z |
| format | Article |
| id | doaj.art-1b2ecf4718de4631ae63fbe69047d7c5 |
| institution | Directory Open Access Journal |
| issn | 1612-3174 |
| language | deu |
| last_indexed | 2024-04-12T00:29:38Z |
| publishDate | 2008-06-01 |
| publisher | German Medical Science GMS Publishing House |
| record_format | Article |
| series | GMS German Medical Science |
| spelling | doaj.art-1b2ecf4718de4631ae63fbe69047d7c52022-12-22T03:55:22ZdeuGerman Medical Science GMS Publishing HouseGMS German Medical Science1612-31742008-06-016Doc04Subacute transverse myelitis with Lyme profile dissociationAjjan, MohammedWalid, M. SamiUlm, Arthur J.Introduction: Transverse myelitis is a very rare neurologic syndrome with an incidence per year of 1-5 per million population. We are presenting an interesting case of subacute transverse myelitis with its MRI (magnetic resonance imaging) and CSF (cerebrospinal fluid) findings. Case: A 46-year-old African-American woman presented with decreased sensation in the lower extremities which started three weeks ago when she had a 36-hour episode of sore throat. She reported numbness up to the level just below the breasts. Lyme disease antibodies total IgG (immunoglobulin G) and IgM (immunoglobulin M) in the blood was positive. Antinuclear antibody profile was within normal limits. MRI of the cervical spine showed swelling in the lower cervical cord with contrast enhancement. Cerebrospinal fluid was clear with negative Borrelia Burgdorferi IgG and IgM. Herpes simplex, mycoplasma, coxiella, anaplasma, cryptococcus and hepatitis B were all negative. No oligoclonal bands were detected. Quick improvement ensued after she was given IV Ceftriaxone for 7 days. The patient was discharged on the 8th day in stable condition. She continued on doxycycline for 21 days. Conclusions: Transverse myelitis should be included in the differential diagnosis of any patient presenting with acute or subacute myelopathy in association with localized contrast enhancement in the spinal cord especially if flu-like prodromal symptoms were reported. Lyme disease serology is indicated in patients with neurological symptoms keeping in mind that dissociation in Lyme antibody titers between the blood and the CSF is possible.http://www.egms.de/en/gms/2008-6/000049.shtmltransverse myelitisLyme disease |
| spellingShingle | Ajjan, Mohammed Walid, M. Sami Ulm, Arthur J. Subacute transverse myelitis with Lyme profile dissociation GMS German Medical Science transverse myelitis Lyme disease |
| title | Subacute transverse myelitis with Lyme profile dissociation |
| title_full | Subacute transverse myelitis with Lyme profile dissociation |
| title_fullStr | Subacute transverse myelitis with Lyme profile dissociation |
| title_full_unstemmed | Subacute transverse myelitis with Lyme profile dissociation |
| title_short | Subacute transverse myelitis with Lyme profile dissociation |
| title_sort | subacute transverse myelitis with lyme profile dissociation |
| topic | transverse myelitis Lyme disease |
| url | http://www.egms.de/en/gms/2008-6/000049.shtml |
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