A case of local tetanus presenting spastic paraplegia mimicking myelitis
| Autor: | Kazumasa Shindo, Mai Tsuchiya, Fumikazu Kobayashi, Yoshihisa Takiyama, Takamura Nagasaka, Nobuo Yamashiro |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male Opisthotonus Myelitis Hyperreflexia Trismus Diagnosis Differential 03 medical and health sciences 0302 clinical medicine Tetanus Toxoid medicine Spastic Humans 030212 general & internal medicine Spasticity Paraplegia Tetanus business.industry medicine.disease Magnetic Resonance Imaging Treatment Outcome Spinal Cord Anesthesia Neurology (clinical) medicine.symptom business 030217 neurology & neurosurgery |
| Zdroj: | Rinsho Shinkeigaku. 58:688-691 |
| ISSN: | 1882-0654 0009-918X |
| Popis: | A 35-year-old male was admitted to our hospital because of suspected myelitis. T2-weighted spinal MRI revealed a high intensity area at Th7-9. On admission, he showed mild weakness of the lower extremities and hyperreflexia of all extremities. Therefore, he was diagnosed with having spastic paraplegia. He presented no trismus or opisthotonos. There was pleocytosis in the cerebral spinal fluid. Dysuria, constipation and spasticity of the bilateral legs worsened, even though we administered methylprednisolone pulse therapy. Nonetheless, the symptoms had progressed on the 11th hospital day, opisthotonus and optic hyperesthesia were presented. On the 13th hospital day, we suspected local tetanus and administered tetanus toxoid. After one month, his symptoms had gradually improved. In the case of spastic paraplegia showing a subacute progression course and a faint abnormality on spinal MRI, the possibility of local tetanus should be considered. |
| Databáze: | OpenAIRE |
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