Longitudinal extensive transverse myelitis-a case report

Abstract

Longitudinal Extensive Transverse Myelitis (LETM) characterized by spinal cord inflammation extending vertically through three or more vertebral segments.Early serological testing for NMO-IgG antibodies in suspected LETM is important for prompt diagnosis, indicating prognosis and establishing appropriate therapy to reduce the risk of future relapses or disease progression. This is a case of 35-year-old female complaining of weakness of both lower limbs, bladder and bowel disturbances with curdle like sensation, loss of sensation.MRI C and D spine plain and contrast showed T2 hyperintensity in spinal from C4 to D7 s/o of demyelination, thinning of spinal cord noted at upper dorsal level. Anti nuclear antibody ELISA test revealed positive indicating the presence of NMO IgG antibodies.Due to poor prognosis of the disease patient was advised to be in observation for 15 days and planned for 2 doses of cyclophosphamide 750 mg.Mean while symptomatic treatment was also given.Performing NMO antibodies test as early as possible in the case of symptomatic assessment of either LETM or Multiple sclerosis, which facilitates the choice of treatment for better patient care and enhanced health related quality of life.