Integrated Rehabilitation of Longitudinal Extensive Transverse Myelitis: Study of a Complex Case

Longitudinal extensive transverse myelitis (LETM) is a rare neurological disorder portrayed by inflammation of the spinal cord spanning three or more vertebral segments. It can lead to severe symptoms such as weakness, sensory abnormalities, and dysfunction in various parts of the body. LETM can be idiopathic or associated with autoimmune conditions like Multiple Sclerosis (MS) and Neuromyelitis Optica (NMO). Diagnosis of LETM requires MRI imaging of the spine, and treatment often involves corticosteroids, intravenous immunoglobulins (IVIG), and plasma exchange. Physical therapy plays a crucial role in managing LETM, focusing on improving functional abilities, mobility, and quality of life. This study outlines a 62-year-old male who was admitted with a complaint of bilateral weakness of both upper and lower limbs, predominantly on the left side, seizures, falls, and stiffness of the left limbs. He also complained of a cough with sputum, cluster headache, bowels and bladder dysfunction, and impaired vision. Neurologic examination showed hypotonia and reduced muscle strength in all four limbs with impairment of the optic nerve. The following investigations were conducted: MRI, Chest X-ray, and ultrasound. He was advised for physiotherapy, after which he showed improvement in functional independence and a general recovery following the treatment.