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