A woman with acute myelopathy in pregnancy: case progression

Last week ( BMJ 2009;339:b3862) we described the case of Andrea G, who presented with acute transverse myelitis extending over eight segments above T8 and associated with mild lymphogranulocytic cerebral spinal fluid pleocytosis. She had hypotonic paraparesis of the legs accentuated on the left side with increased reflexes. Her dissociated sensory deficit below T8 progressed to a global sensory deficit consistent with incomplete transverse spinal cord syndrome. Acute cord lesions can cause an initial hypotonic weakness with reflexes becoming accentuated later, as seen in this case, or being depressed. We treated Mrs G with high dose intravenous …