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Concurrent transverse myelitis and acute inflammatory demyelinating polyneuropathy
  1. Matthew Shrimpton and
  2. Cameron Shaw
  1. Neurology Department, Barwon Health, Geelong, Victoria, Australia
  1. Correspondence to Dr Matthew Shrimpton; m.shrimpton{at}deakin.edu.au

Abstract

A woman in her 40s presented with thoracic banding dysaesthesia and lower motor neuron weakness. Spinal imaging revealed a short segment of transverse myelitis and neurophysiology was suggestive of concurrent acute inflammatory demyelinating polyneuropathy. The patient improved with consecutive intravenous immunoglobulin and methylprednisolone treatment. Acute inflammatory demyelinating polyneuropathy is a progressive immune-mediated peripheral neuropathy which responds to intravenous immunoglobulin or plasmapheresis, whereas transverse myelitis is a central inflammatory syndrome usually treated with corticosteroid. We highlight differentiating features of the clinical presentation and the utility of investigations such as neurophysiology and MRI along with a review of treatment and the role for corticosteroid therapy.

  • neurology
  • clinical neurophysiology
  • peripheral nerve disease
  • spinal cord

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Footnotes

  • Contributors MS was responsible for manuscript draft. CS assisted with editing and supervision. MS and CS were responsible for drafting of the text, sourcing and editing of clinical images, investigating results, drawing original diagrams and algorithms and critically revising for important intellectual content. MS and CS gave final approval of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.