Transient acute tetraparesis revealing bihemispheric cerebral infarcts.

A 74-year-old woman with a history of diabetes mellitus developed acute tetraparesis. The symptoms totally resolved in 15 min. Neurological examination performed 2 days after the symptoms onset was normal. Brain magnetic resonance imaging (MRI), performed 3 days after onset, showed on diffusion-weighted imaging bihemispheric cerebral infarcts (Fig. 1). Electrocardiogram, chest X-ray and laboratory studies were normal. Carotid ultrasonography, transthoracic and transoesophageal echocardiography were normal. The patient was discharged 10 days after admission on antiplatelet and antihypertensive agents, with a favourable outcome. This patient suffered from acute and transient tetraparesis revealing bihemispheric cerebral infarctions. The present case is of interest for two reasons. First, although tetraparesis may initially suggest spinal cord lesion, bilateral cerebral involvement should always be considered, particularly in the case of acute symptoms onset. Second, this case underlines the fact that all acute clinical symptoms, even for neurological events that are less than 1 h, should be investigated ideally with MRI.