Presentation
Sudden onset weakness and difficulty in walking.
Patient Data
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Ill defined T2/FLAIR hyperintense lesions in bilateral posterior limbs internal capsules, globi palladi and left middle cerebellar peduncle.
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Motion artifacts are seen degrading anatomical details.
Intramedullary hyperintensity is seen from C6-7 to T7 levels with mild expansion of cord suggesting transverse myelitis. No obvious enhancement is seen on post-contrast scan.
Case Discussion
Asymmetric T2/FLAIR hyperintensities in the brain with transverse myelitis in the cord suggests likelihood of demyelination. In view of involvement of middle cerebellar peduncle, the possibility of myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) was high, which was later confirmed on laboratory work-up.