Case Report

Volume: 3 | Issue: 3 | Published: Sep 12, 2019 | Pages: 119 - 122 | DOI: 10.24911/ejmcr/173-1561798736

Extensive spinal leptomeningeal enhancement in neuromyelitis optica spectrum disorders: a case report


Authors: Wei Kok Poh , Zaidatul Wahida Abd Wahab , Yong Chin Kok


Article Info

Authors

Wei Kok Poh

Internal Medicine, Hospital Tuanku Jaafar Seremban, Malaysia

Zaidatul Wahida Abd Wahab

Radiology, Hospital Tuanku Jaafar Seremban, Malaysia

Yong Chin Kok

Internal Medicine, Hospital Tuanku Ja'afar Seremban, Malaysia

Publication History

Received: June 29, 2019

Revised: July 24, 2019

Accepted: August 05, 2019

Published: September 12, 2019


Abstract


Background: Cortical involvement and leptomeningeal enhancement are rare in neuromyelitis optica spectrum disorder (NMOSD). Cerebrospinal fluid (CSF) total protein is usually raised typically ranged between 0.5 and 1.5 g/l. Case Presentation: A 22-year old lady who was previously well presented with a subacute onset of bilateral lower limb weakness for 1 week, which progressed in an ascending pattern involving the upper limbs. Magnetic resonance imaging spine showed longitudinally extensive transverse myelitis as well as leptomeningeal enhancement of the entire spine. CSF protein was high with 3.33 g/l. Serum Aquaporin-4 IgG was positive. After failed steroid therapy, she responded dramatically with plasma exchange. Conclusion: The presence of very high CSF protein and the presence of extensive leptomeningeal enhancement should not dissuade clinicians from considering the diagnosis of NMOSD, but merely reflects its severity and may need aggressive immunotherapy such as combination of steroids and plasma exchange.

Keywords: Neuromyelitis optica spectrum disorders, spinal leptomeningeal enhancement, aquaporin-4 IgG, longitudinally extensive transverse myelitis, green


Pubmed Style

Wei Kok Poh, Zaidatul Wahida Abd Wahab, Yong Chin Kok. Extensive spinal leptomeningeal enhancement in neuromyelitis optica spectrum disorders: a case report. EJMCR. 2019; 12 (September 2019): 119-122. doi:10.24911/ejmcr/173-1561798736

Web Style

Wei Kok Poh, Zaidatul Wahida Abd Wahab, Yong Chin Kok. Extensive spinal leptomeningeal enhancement in neuromyelitis optica spectrum disorders: a case report. https://ejmcr.com/articles/1477 [Access: December 25, 2024]. doi:10.24911/ejmcr/173-1561798736

AMA (American Medical Association) Style

Wei Kok Poh, Zaidatul Wahida Abd Wahab, Yong Chin Kok. Extensive spinal leptomeningeal enhancement in neuromyelitis optica spectrum disorders: a case report. EJMCR. 2019; 12 (September 2019): 119-122. doi:10.24911/ejmcr/173-1561798736

Vancouver/ICMJE Style

Wei Kok Poh, Zaidatul Wahida Abd Wahab, Yong Chin Kok. Extensive spinal leptomeningeal enhancement in neuromyelitis optica spectrum disorders: a case report. EJMCR. (2019), [cited December 25, 2024]; 12 (September 2019): 119-122. doi:10.24911/ejmcr/173-1561798736

Harvard Style

Wei Kok Poh, Zaidatul Wahida Abd Wahab, Yong Chin Kok (2019) Extensive spinal leptomeningeal enhancement in neuromyelitis optica spectrum disorders: a case report. EJMCR, 12 (September 2019): 119-122. doi:10.24911/ejmcr/173-1561798736

Chicago Style

Wei Kok Poh, Zaidatul Wahida Abd Wahab, Yong Chin Kok. "Extensive spinal leptomeningeal enhancement in neuromyelitis optica spectrum disorders: a case report." 12 (2019), 119-122. doi:10.24911/ejmcr/173-1561798736

MLA (The Modern Language Association) Style

Wei Kok Poh, Zaidatul Wahida Abd Wahab, Yong Chin Kok. "Extensive spinal leptomeningeal enhancement in neuromyelitis optica spectrum disorders: a case report." 12.September 2019 (2019), 119-122. Print. doi:10.24911/ejmcr/173-1561798736

APA (American Psychological Association) Style

Wei Kok Poh, Zaidatul Wahida Abd Wahab, Yong Chin Kok (2019) Extensive spinal leptomeningeal enhancement in neuromyelitis optica spectrum disorders: a case report. , 12 (September 2019), 119-122. doi:10.24911/ejmcr/173-1561798736