A Rare Case of Myeloradiculitis with Positive Antinuclear Antibody and Toxocariasi

초록

A rare case of myeloradiculitis with positive antinuclear antibody and toxocariasis Introduction Myelitis affects the spinal cord, causing motor weakness, sensory deficits and autonomic dysfunction. Radiculitis affects nerve roots, causing motor weakness, among other symptoms. Identifying the underlying cause can be challenging. In this case report, we highlight a rare instance of a patient with myeloradiculitis with toxocariasis, emphasizing the importance of recognizing and addressing co-existing neurological conditions. Case A 69-year-old female presented to the emergency room the day after experiencing dizziness, along with hypoesthesia in both posterior lower legs (S1 dermatome). Despite normal muscle strength, the patient declined a spine magnetic resonance image (MRI) and opted for admission to another hospital. However, the following day, she returned to the emergency room with hypoesthesia in the L5-S5 dermatomes, progressive motor weakness in both lower limbs, urinary retention, and constipation. Brain MRI revealed a slightly aggravated state of small vessel disease, while spine MRI showed focal linear enhancement at the T12-L1 level of the spinal cord (Figure 1). She was suggested with acute transverse myelitis and treated with methylprednisolone (1g for 5 days). On hospital day 6, a follow-up MRI revealed segmental swelling with enhancement at the central spinal cord/conus medullaris (T11-L1 level) (Figure 1). She received prednisolone and physical therapy. On the other hand, Deep tendon reflexes were decreased bilaterally in the knees and ankles. Initial cerebrospinal fluid (CSF) analysis showed an RBC count of 1/mm3, WBC count of 1/mm3, protein level of 56.7mg/dL, and glucose level of 70mg/dL. Nerve conduction studies (NCS) on hospital day 4 revealed a delayed dis