Case history
Case history #1
A 26-year-old woman with no significant medical history presents with a 5-day history of left lower extremity paraesthesias that subsequently ascended the left trunk to the level of the umbilicus. She also reports new-onset urinary frequency and that her right leg drags during ambulation. On examination, she has a partial Brown-Sequard's syndrome with mild pyramidal weakness and impairment of vibration and proprioceptive sensation involving the right lower extremity, and reduced appreciation for pain throughout the left lower extremity and trunk below T11. The right plantar response is extensor.
Case history #2
A 45-year-old woman with a history of Hashimoto's thyroiditis presents with a 2-day history of progressive bilateral upper and lower extremity numbness, paraparesis, bladder incontinence, mid-thoracic back pain, and L'hermitte's sign (limb paresthesias upon neck flexion). On examination, she has 4/5 power in the distal upper extremities, 1/5 power in her lower extremities with symmetric hyper-reflexia, clonus, and Babinski's signs. There is a bilateral sensory level at T4 and loss of vibratory and proprioceptive sensation in the feet, and she is unable to walk.
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