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BMC Neurology

, 17:13

Demyelinating diseases


BackgroundLongitudinally Extensive Transverse Myelitis LETM is a specific pattern of myelitis wherein at least three continuous vertebral segments are involved. Characteristically, it is a defining feature of neuromyelitis optica NMO. However, it is described in many other etiologies.

Case presentationWe present a case of 60 year old male who presented with symptoms and signs of regional sympathetic dystrophy RSD followed by symptoms of myelitis. Spinal cord MRI revealed cervical LETM extending to the brainstem. In spite of serological negativity, treatment of suspected neuromyelitis optica spectrum disorder NMOSD was initiated and resulted in symptom relief. Meanwhile, sudden death occurred and autonomic dysreflexia was the main culprit.

ConclusionsThis case suggests that RSD could be the mere primary presentation of LETM, discusses the differential diagnoses of LETM in elderly patients, and suggests the possible risk of autonomic dysreflexia in such patients.

KeywordsLETM RSD NMOSD Cervical spinal tumor AbbreviationsADEMAcute disseminated encephalomyelitis

ANAAntinuclear antibodies

ANCAAnti neutrophil cytoplasmic autoantibodies

AQP4-IgGAquaporin-4 IgG


CBCComplete blood count

CSFCerebrospinal fluid

CTComputed tomography

DTRSDeep tendon reflexes

HEENTHead, eyes, ears, nose and throat.


LETMLongitudinally Extensive Transverse Myelitis

LFTsLiver function tests.

MRIMagnetic resonance imaging

MSMultiple sclerosis.

NMONeuromyelitis optica

NMOSDNeuromyelitis optica spectrum disorder

RSDRegional sympathetic dystrophy

SLESystemic lupus erythromatosus

SS-A and BAnti Sjogren’s syndrome-related antigen

VEPVisually evoked potentials test

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Autor: Rana Alnasser Alsukhni - Yasmin Aboras - Ziena Jriekh - Mahmoud Almalla - Ahmad Sheikh El-Kahwateya

Fuente: https://link.springer.com/

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