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Published on: August 21, 2017
Acute cervical segmental denervation in neuromyelitis optica spectrum disorder
Prompan Mingbunjerdsuk1, Bashar Katirji
1Neurological Institute, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, OH.
Objectives:
Neuromyelitis optica (NMO) is an inflammatory demyelinating disease of central nervous system. We report a case of NMO spectrum disorder that developed acute cervical segmental denervation during an episode of transverse myelitis.
Methods:
Case report and a literature review.
Results:
A 69-year-old woman presented with right leg weakness, which improved in 2 weeks of intravenous methylprednisolone. Six weeks later, she returned with recurrent transverse myelitis followed by left hand weakness and atrophy. Electromyography showed active denervation on left C8/T1-innervated muscles. Magnetic resonance imaging of thoracic spine showed patchy T2-signal enhancement from T10 to lower cervical spine. NMO antibody was positive. Review of literature revealed 5 cases of cervical transverse myelitis that developed denervation on electromyography.
Conclusions:
Segmental denervation may occur in NMO and variants resulting from severe myelitis extending to involve gray and white matter leads to anterior horn cell loss.
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