Abstract

CASE REPORT ON TRANSVERSE MYELITIS

*Anna B. Varghese, Lakshmi and Dr. Akhila Ann Cherian

Abstract

Background: Transverse myelitis (TM) is an uncommon spinal cord inflammatory disease that causes impairment in the motor, sensory, and autonomic nervous systems. It may have autoimmune, infectious, or paraneoplastic causes, or it may be idiopathic. Improving neurological outcomes requires early detection and prompt action. Case Presentation: A 30-year-old man complained of sensory deficiencies, growing weakening in both lower limbs, and searing pain in his left lower back. Upon evaluation, he showed significant lower limb weakness (1/5) but preserved upper limb strength (5/5). Joint position sensation and vibration were reduced, and deep tendon reflexes were non-existent in the lower limbs and quick in the upper limbs. Multilevel posterior disc bulges with spinal canal narrowing were seen on the dorsal spine MRI, although there were no unusual T2 hyperintensities. Imaging of the cervical spine revealed no discernible disc herniation. A CSF investigation showed minor pleocytosis (2 cells), a protein level of 60 mg/dL, and a sugar level of 68 mg/dL. Aquaporin-4 antibodies, fungal stains, AFB, and CSF culture were all negative. Anti-MOG antibodies, however, showed a slight positive result, indicating an autoimmune cause. After receiving intravenous methylprednisolone (1 g/day) and plasmapheresis for five cycles, the patient's symptoms significantly improved. Conclusion: The significance of taking anti-MOG-associated TM into account in patients with unexplained myelopathy is demonstrated by this case. Improving results requires prompt immunomodulatory treatment, such as plasmapheresis and corticosteroids, and early diagnosis. Increasing knowledge on autoimmune-mediated TM can help in early diagnosis and improved prognosis.

Keywords: Transverse myelitis, MOG antibody-associated disease (MOGAD), Inflammatory myelopathy, Plasmapheresis, Corticosteroids.