Idiopathic Transverse Myelitis in a 20-Year-Old Male

Speaker Credentials

MS-III

Speaker Credentials

MS

College

College of Allopathic Medicine

Medical Specialty

Internal Medicine

Format

Poster

Start Date

November 2024

End Date

November 2024

Track

4

Abstract

Idiopathic Transverse Myelitis in a 20-Year-Old Male Ann Lowery Black, MD1, Patricia Milanes, MS32, Veronica Benitez, MS32, Alejandro Del Cerro Rondon MD1 1. HCA Kendall Hospital & 2. Nova Southeastern University – Dr. Kiran C. Patel College Of Allopathic Medicine (NSU MD), Davie, FL, USA

Introduction: Transverse myelitis is a rare spinal cord inflammation characterized by motor, sensory, and autonomic symptoms below the affected segment. Its incidence is 1 to 8 new cases per million annually, with peaks around ages 10, 20, and over 40, affecting both genders equally. Although 15-30% of cases are idiopathic, causes can include parainfectious diseases, demyelinating disorders, systemic inflammatory autoimmune disorders, neurosarcoidosis, and drug agents. Symptoms peak between 4 hours and 21 days, presenting as paresis, numbness, paresthesias, dysesthesia, and bladder/bowel incontinence. Diagnosis involves absence of a compressive lesion and evidence of inflammatory process on MRI, pleocytosis on CSF analysis, and a rise in inflammatory markers.

Case Presentation: We present a 20-year-old male with no significant medical history who presented with bilateral tingling and pulsing heat in his hands and feet. Throughout the course of his stay, he developed high fevers, sustained tachycardia, and facial edema.

Deviation From the Expected: The patient had a rare disorder and despite the extensive workup, no cause was identified.

Discussion: MRI of the cervical spine and lumbar spine were performed, concerning for a multilevel demyelinating process in the spine which confirmed the diagnosis. A lumbar puncture was done, and CSF fluid was negative for active infectious markers and positive for nonspecific inflammatory changes.

Conclusion: In this case, the patient was given five days of intravenous methylprednisolone with intravenous acyclovir, which led to the complete resolution of symptoms and the patient’s subsequent discharge.

Grants: This study was not funded by any grant or institution.

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Nov 13th, 10:12 AM Nov 13th, 10:20 AM

Idiopathic Transverse Myelitis in a 20-Year-Old Male

Idiopathic Transverse Myelitis in a 20-Year-Old Male Ann Lowery Black, MD1, Patricia Milanes, MS32, Veronica Benitez, MS32, Alejandro Del Cerro Rondon MD1 1. HCA Kendall Hospital & 2. Nova Southeastern University – Dr. Kiran C. Patel College Of Allopathic Medicine (NSU MD), Davie, FL, USA

Introduction: Transverse myelitis is a rare spinal cord inflammation characterized by motor, sensory, and autonomic symptoms below the affected segment. Its incidence is 1 to 8 new cases per million annually, with peaks around ages 10, 20, and over 40, affecting both genders equally. Although 15-30% of cases are idiopathic, causes can include parainfectious diseases, demyelinating disorders, systemic inflammatory autoimmune disorders, neurosarcoidosis, and drug agents. Symptoms peak between 4 hours and 21 days, presenting as paresis, numbness, paresthesias, dysesthesia, and bladder/bowel incontinence. Diagnosis involves absence of a compressive lesion and evidence of inflammatory process on MRI, pleocytosis on CSF analysis, and a rise in inflammatory markers.

Case Presentation: We present a 20-year-old male with no significant medical history who presented with bilateral tingling and pulsing heat in his hands and feet. Throughout the course of his stay, he developed high fevers, sustained tachycardia, and facial edema.

Deviation From the Expected: The patient had a rare disorder and despite the extensive workup, no cause was identified.

Discussion: MRI of the cervical spine and lumbar spine were performed, concerning for a multilevel demyelinating process in the spine which confirmed the diagnosis. A lumbar puncture was done, and CSF fluid was negative for active infectious markers and positive for nonspecific inflammatory changes.

Conclusion: In this case, the patient was given five days of intravenous methylprednisolone with intravenous acyclovir, which led to the complete resolution of symptoms and the patient’s subsequent discharge.

Grants: This study was not funded by any grant or institution.