Transverse Myelitis in a 72-Year-Old Male Presenting With Upper Extremity Weakness

Area of Science:

• Neuroscience
• Immunology
• Spinal Cord Disorders

Background:

• Acute transverse myelitis (TM) is a rare neuro-immune disorder affecting the spinal cord, typically seen in younger or middle-aged adults.
• TM can manifest with motor weakness, sensory changes, and bowel/bladder dysfunction, stemming from idiopathic causes or secondary diseases.

Observation:

• A 72-year-old male with hypertension and type 2 diabetes presented with bilateral upper extremity weakness and abdominal numbness.
• Initial symptoms included neck discomfort after travel, with no reported injury.
• Diagnostic workup included magnetic resonance imaging (MRI) and lumbar puncture.

Findings:

• The patient was diagnosed with acute transverse myelitis (TM).
• The underlying etiology was identified as a new diagnosis of Sjögren's autoimmune disease.
• Treatment involved high-dose intravenous steroids, with plans for oral continuation.

Implications:

• This case underscores the importance of considering TM in older adults, challenging typical age demographics.
• Prompt diagnosis and treatment of TM, particularly when secondary to autoimmune conditions like Sjögren's, are crucial for preventing further neurological damage.
• Physician awareness is vital for timely recognition and management of treatable TM etiologies.