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A case of local tetanus presenting spastic paraplegia mimicking myelitis
- Source :
- Rinsho Shinkeigaku. 58:688-691
- Publication Year :
- 2018
- Publisher :
- Societas Neurologica Japonica, 2018.
-
Abstract
- A 35-year-old male was admitted to our hospital because of suspected myelitis. T2-weighted spinal MRI revealed a high intensity area at Th7-9. On admission, he showed mild weakness of the lower extremities and hyperreflexia of all extremities. Therefore, he was diagnosed with having spastic paraplegia. He presented no trismus or opisthotonos. There was pleocytosis in the cerebral spinal fluid. Dysuria, constipation and spasticity of the bilateral legs worsened, even though we administered methylprednisolone pulse therapy. Nonetheless, the symptoms had progressed on the 11th hospital day, opisthotonus and optic hyperesthesia were presented. On the 13th hospital day, we suspected local tetanus and administered tetanus toxoid. After one month, his symptoms had gradually improved. In the case of spastic paraplegia showing a subacute progression course and a faint abnormality on spinal MRI, the possibility of local tetanus should be considered.
- Subjects :
- Adult
Male
Opisthotonus
Myelitis
Hyperreflexia
Trismus
Diagnosis, Differential
03 medical and health sciences
0302 clinical medicine
Tetanus Toxoid
medicine
Spastic
Humans
030212 general & internal medicine
Spasticity
Paraplegia
Tetanus
business.industry
medicine.disease
Magnetic Resonance Imaging
Treatment Outcome
Spinal Cord
Anesthesia
Neurology (clinical)
medicine.symptom
business
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 18820654 and 0009918X
- Volume :
- 58
- Database :
- OpenAIRE
- Journal :
- Rinsho Shinkeigaku
- Accession number :
- edsair.doi.dedup.....7daf527fbae67c33657c73bce174e610