n South African Medical Journal - A young woman with weakness of the legs : continuing medical education : case report
|Article Title||A young woman with weakness of the legs : continuing medical education : case report|
|© Publisher:||Health and Medical Publishing Group (HMPG)|
|Journal||South African Medical Journal|
|Affiliations||1 University of Cape Town and 2 University of Cape Town|
|Publication Date||Feb 2014|
A previously well 22-year-old woman presented with progressive weakness of her legs and urinary incontinence over 7 days. Clinically she was healthy, with no skin rashes. On neurological examination she had profound bilateral weakness of the lower limbs, hypertonia, hyperreflexia, a positive Babinski sign and a T6 sensory level. Tests for syphilis and HIV and screening for auto-immune conditions were negative. Magnetic resonance imaging (MRI) of the brain and spinal cord revealed extensive cord swelling between the craniocervical junction and T11, a high signal in the right optic nerve and a normal brain. Aquaporin 4 antibodies (neuromyelitis optica immunoglobulin G (NMO-IgG)) were positive with a titre of 1:1 000. These findings confirmed a diagnosis of NMO or Devic's disease.
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