Tingling, Numbness in Lower Limbs: A Case Study

August 23, 2017

What do these images suggest is the cause of bilateral lower limb symptoms of 4 months’ duration?

The patient presents with tingling and numbness in both lower limbs for four months. Scroll through the slides

Sagittal T1WI showed diffuse abnormal isointense lesions occupying more than two-thirds of the spinal cord at mid-dorsal cord region at D4-5 and D7-8 levels associated with minimal dilatation of central canal

Sagittal and axial T2WI revealed hyperintensity of the lesions.

Sagittal DWI showed slight hyperintensity of the lesions denoting unrestricted diffusion.

ADC map showed low signal intensity of the lesions denoting unrestricted diffusion.

ADC map showed low signal intensity of the lesions denoting unrestricted diffusion (Figure 5). ADC value was measured at (b=1000) 1.1×10–3 mm2/s.

What do these images suggest is the cause of bilateral lower limb symptoms of 4 months’ duration?

Diagnosis: Transverse myelitis

References
1.Chamberlin SL, Narins B. The Gale Encyclopedia of Neurological Disorders. Detroit: Thomson Gale (2005): pp. 1859–1870.
2.Transverse Myelitis Consortium Working Group (TMCWG). Proposed diagnostic criteria and nosology of acute transverse myelitis. Neurology. 2002;59:499–505.