Transverse myelitis - Devic disease

Case contributed by A.Prof Frank Gaillard

Presentation

Acute paraparesis.

Patient Data

Age: 18 years
Gender: Male

Extensive increased T2 signal and expansion of the cord is seen extending between C7 and T12. The T2 signal abnormality involves central grey matter and dorsal columns.  Linear sagittally oriented enhancement is seen posteriorly within the cord in the mid and lower thoracic cord.   

The left hypothalamus, mammillary body, and immediately adjacent portion of the optic chiasm and optic tract are of abnormally high signal intensity, no restricted diffusion or abnormal contrast enhancement.  Cerebral parenchymal signal intensity and architecture are otherwise normal.  Ventricles and sulci are normal for the patient's age.  Normal flow voids are seen from the major arteries at the base of the brain. 

Case Discussion

CSF demonstrated a lymphocytosis. 

Treatment was commenced including azathiaprine, intragram and prednisolone with gradual recovery of function. 

A repeat MRI 4 months later (not shown) demonstrated complete resolution of changes with a normal spinal cord. 

PlayAdd to Share

Case information

rID: 19649
Case created: 30th Sep 2012
Last edited: 4th Nov 2015
Inclusion in quiz mode: Included

Updating… Please wait.
Loadinganimation

Alert accept

Error Unable to process the form. Check for errors and try again.

Alert accept Thank you for updating your details.