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Published on: November 9, 2017
[Acute idiopathic longitudinally extensive transverse myelitis with peripheral axonal motor neuropathy]
Abstract:
Acute longitudinally extensive transverse myelitis (LETM) is a rare disease of autoimmune, connective tissue or infectious etiology (bacterial or viral) in which spinal cord lesion extends vertically over three or more vertebral segments. The most common cause of LETM is neuromyelitis optica (Devic's syndrome). It's typically clinically characterized by a tetraparesis or paraparesis of the lower extremities, superficial and deep sensation disturbances and sphincter dysfunction. Differential diagnosis is complex and based on immunological, serological, biochemical tests. Authors present 37-year-old healthy woman with sudden onset of flaccid tetraplegia preceded by upper limbs paresthesia. MRI examination of cervical and thoracic part of the spinal cord revealed extensive, multiple hyperintensive lesions extending from C3 up toTh9. In electroneurography examination coexistent severe peripheral axonal motor neuropathy was diagnosed. Despite performed profound tests the etiology of LETM in our patient remained unknown.
Insights
This case study details a rare case of longitudinally extensive transverse myelitis (LETM) in a healthy woman, presenting with severe paralysis and diagnosed neuropathy. The exact cause of her LETM remained undetermined despite extensive testing.
Area of Science:
- Neurology
- Immunology
- Infectious Diseases
Background:
- Longitudinally extensive transverse myelitis (LETM) is a rare spinal cord disorder affecting three or more vertebral segments.
- Commonly associated with neuromyelitis optica (Devic's syndrome), LETM can also stem from autoimmune, connective tissue, or infectious causes.
- Clinical presentation often includes lower extremity weakness, sensory disturbances, and sphincter dysfunction.
Observation:
- A 37-year-old woman experienced sudden flaccid tetraplegia and upper limb paresthesia.
- MRI revealed extensive spinal cord lesions from C3 to Th9.
- Electroneurography indicated a coexistent severe peripheral axonal motor neuropathy.
Findings:
- The patient presented with acute LETM and concurrent peripheral neuropathy.
- Despite comprehensive diagnostic evaluations, the specific etiology of LETM in this case was not identified.
- Differential diagnosis for LETM involves complex immunological, serological, and biochemical testing.
Implications:
- This case highlights the diagnostic challenges in identifying the etiology of LETM, even with advanced testing.
- It underscores the potential for coexisting peripheral neuropathies in LETM patients.
- Further research may be needed to elucidate rare or idiopathic causes of LETM.
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