Abstract:
Introduction. Transverse Myelitis is a rare neurological disorder, often without any known cause but with
an important negative effect on patients quality of life. The neurological symptoms provided by the
transverse Myelitis take the form of motor, sensory and autonomic dysfunctions. It has a slow onset but a
progressive course and it’s linked to an important loss in patients quality of life.
Case presentation. We present the case of a 71 years male patient with clear progressive spinal cord related
neurological symptoms but with repeated normal laboratory and imagistic findings in the first 6 months
since its onset. Pathological imagistic signs could be detected only at the stage in which the patient already
suffered an important loss in the quality of life.
Discussion. Even at 2 months since onset there were no pathological laboratory and imagistic findings
which made a nearly impossible differentiation between transverse Myelitis and Guillain-Barre Syndrome.
Under a treatment with intravenous immunoglobulins we could temporarily reach a significant reduction
in motor dysfunction, although sensory and autonomic dysfunctions remained unchanged. The course of
the motor, sensory and autonomic dysfunctions showed 3 distinct patterns: motor- slow onset and a
temporary relief under treatment, sensory- later onset but no relief under treatment, and autonomic early
onset and no changes during the entire course. Only a repeated MRI with contrast enhancement at 6 months
since onset could provide a confident explanation of the ongoing pathology, timepoint at which the patient
already suffered an important loss of his quality of life.
Conclusion. Early diagnostics require a detailed anamnesis and comprehensive physical examination, a
continuous monitoring and a correct and prompt use of the necessary laboratory and imagistic techniques.
Sometimes setting the right diagnosis requires several repeated laboratory and imagistic techniques.
