Case 7: Chief Complaint: Paraplegia and Encephalopathy

Benjamin Greenberg, MD

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?

Transverse myelitis
Multiple sclerosis
Devic's syndrome
Vascular malformation
Unknown

View the correct answer.

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Cite this: Case 7: Chief Complaint: Paraplegia and Encephalopathy - Medscape - Dec 15, 2004.

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Case 7: Chief Complaint: Paraplegia and Encephalopathy

History Continued

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