Case 7: Chief Complaint: Paraplegia and Encephalopathy

Benjamin Greenberg, MD

In This Article

History Continued

The patient was admitted to the hospital and evaluated for progressive myelopathy. A work-up consisted of a brain MRI, blood work, and cerebrospinal fluid (CSF) studies:

  • Brain MRI: "normal";

  • CBC: mild anemia;

  • Erythrocyte sedimentation rate (ESR): 96 mm/hour (normal for age: < 20 mm/hour);C-reactive protein (CRP): 63.4 mg/L (normal: < 3 mg/L);Negative Lyme antibody;

  • RPR nonreactive;

  • Negative HIV enzyme-linked immunosorbent assay (ELISA);

  • Negative antinuclear antibody (ANA);

  • Negative serum protein electrophoresis (SPEP); and

  • Negative antineutrophil cytoplasmic antibody (ANCA).

CSF studies:

  • red blood cell count, 2

  • White blood cells count, 2

  • Protein, 49

  • Oligoclonal bands, negative

Given the most recent findings, what would be the most likely diagnosis?

  1. Transverse myelitis

  2. Multiple sclerosis

  3. Devic's syndrome

  4. Vascular malformation

  5. Unknown

View the correct answer.


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