A Catastrophic-Onset Longitudinal Myelitis Accompanied by Bilateral Internuclear Ophthalmoplegia in a Patient with Systemic Lupus Erythematosus
Open Access
- 1 January 2005
- journal article
- case report
- Published by Korean Academy of Medical Sciences in Journal of Korean Medical Science
- Vol. 20 (6), 1085-1088
- https://doi.org/10.3346/jkms.2005.20.6.1085
Abstract
Transverse myelitis (TM) extending from midbrain to the entire spinal cord accompanied by internuclear ophthalmoplegia is extremely rare but cause serious central nervous system complications in patients with systemic lupus erythematosus. We report a case of a 28-yr-old woman with TM extending from the midbrain to the conus medullaris longitudinally and internuclear ophthalmoplegia associated with systemic lupus erythematosus. Her neurological symptoms had an abrupt catastrophic onset and rapidly progressed to respiratory failure within 24 hr. Bilateral internuclear ophthalmoplegia was also followed by TM. Brain MR images showed definite brainstem lesions, which were deeply associated with internuclear ophthalmoplegia, and diffuse signal changes in the whole spinal cord, medulla, pons and midbrain. Clinical improvement of her ophthalmoplegia and of neurological dysfunction of the upper extremities was noted after prompt and aggressive treatment with intravenous pulsed methylprednisolone and cyclophosphamide. However, the neurological dysfunction of the lower limbs and bladder and colon paralysis were almost unchanged until six months passed.Keywords
This publication has 19 references indexed in Scilit:
- Longitudinal myelitis associated with systemic lupus erythematosus: clinical features and magnetic resonance imaging of six casesLupus, 2001
- Involvement of the Entire Spinal Cord and Medulla Oblongata in Acute Catastrophic-Onset Transverse Myelitis in SLEClinical Rheumatology, 2000
- Transverse myelopathy in systemic lupus erythematosus: an analysis of 14 cases and review of the literatureAnnals Of The Rheumatic Diseases, 2000
- Longitudinal involvement of the spinal cord in a patient with lupus related transverse myelitis.1999
- Internuclear ophthalmoplegia in systemic lupus erythematosusSeminars in Arthritis and Rheumatism, 1998
- Lupus transverse myelopathy: better outcome with early recognition and aggressive high-dose intravenous corticosteroid pulse treatmentZeitschrift für Neurologie, 1995
- Bitemporal hemianopia due to chiasmal optic neuritisNeuro-Ophthalmology, 1987
- The neuro-ophthalmology of systemic lupus erythematosusDocumenta Ophthalmologica, 1979
- The prognosis of acute and subacute transverse myelopathy based on early signs and symptomsAnnals of Neurology, 1978
- Transverse Myelopathy in Systemic Lupus ErythematosusAnnals of Internal Medicine, 1975