Motor axonal neuropathy in sequence with acute transverse myelitis

Abstract

Acute transverse myelitis (ATM) is an upper motor neuron disease of the spinal cord, and its association with peripheral polyneuropathy, particularly the axonal type, is rarely reported. This case presented with features of noncompressive upper motor neuron type of quadriplegia with bladder, bowel and sensory involvement at C4 spinal level. The diagnosis of ATM was confirmed by magnetic resonance imaging scan. The patient responded to high-dose steroids and was discharged. However, after 2 weeks of recovery, the patient again developed acute-onset pure motor flaccid paralysis. Nerve conduction test was diagnostic of pure motor axonal neuropathy. This time she was treated with immunoglobulins after which she improved.