A case of subacute myelitis associated with primary Sjögren syndrome showing no MRI abnormality and diagnosed by somatosensory evoked potentials

Soichiro Fushimi, Isao Nagano, Kentaro Deguchi, Shoko Nagotani, Tetsuro Murakami, Mikio Shoji, Koji Abe

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

We describe a case of Sjögren syndrome presenting with subacute transverse myelopathy that improved in response to steroid therapy. A 55-year-old woman with a history of NIDDM developed progressive sensory disturbance and weakness of the both legs, and micturition disturbance during a 6-month period, resulting in walking difficulty. On admission, neurological examination revealed paraplegia with extensor plantar reflex and sensory disturbance below Th 6 level. Lumbar puncture disclosed a normal cell count and a mild elevation of protein in the CSF. As subacute myelitis at the level of Th 6 was suspected, spinal plain and enhanced MRI was performed, which revealed no abnormalities. In contrast, tibial somatosensory evoked potential (SEP) could not be evoked while median SEP was almost normal, indicating thoracic cord involvement. She was diagnosed with primary Sjögren syndrome based on xerostomia, apple-tree appearance in parotid sialography, mononuclear cell infiltration in the salivary gland biopsied, and elevated anti-SS-A and SS-B antibody titers. We considered that her myelopathy was associated with Sjögren syndrome, and started steroid pulse therapy. After three courses of steroid pulse therapy followed by oral prednisolone, she showed clinical and SEP improvements. It is conceivable that the present case may represent Sjögren syndrome complicated with myelopathy that shows no MRI abnormality and well responds to steroid therapy. SEP can be a valuable tool for assessing the presence and severity of spinal cord involvement, and the efficacy of treatments.

Original languageEnglish
Pages (from-to)1029-1034
Number of pages6
JournalBrain and Nerve
Volume56
Issue number12
Publication statusPublished - Dec 2004

Fingerprint

Myelitis
Somatosensory Evoked Potentials
Spinal Cord Diseases
Steroids
Spinal Cord
Babinski's Reflex
Sialography
Mobility Limitation
Xerostomia
Spinal Puncture
Urination
Paraplegia
Neurologic Examination
Malus
Therapeutics
Prednisolone
Salivary Glands
Type 2 Diabetes Mellitus
Leg
Cell Count

Keywords

  • MRI
  • Myelopathy
  • SEP
  • Sjögren syndrome
  • Steroid

ASJC Scopus subject areas

  • Neuroscience(all)

Cite this

A case of subacute myelitis associated with primary Sjögren syndrome showing no MRI abnormality and diagnosed by somatosensory evoked potentials. / Fushimi, Soichiro; Nagano, Isao; Deguchi, Kentaro; Nagotani, Shoko; Murakami, Tetsuro; Shoji, Mikio; Abe, Koji.

In: Brain and Nerve, Vol. 56, No. 12, 12.2004, p. 1029-1034.

Research output: Contribution to journalArticle

Fushimi, S, Nagano, I, Deguchi, K, Nagotani, S, Murakami, T, Shoji, M & Abe, K 2004, 'A case of subacute myelitis associated with primary Sjögren syndrome showing no MRI abnormality and diagnosed by somatosensory evoked potentials', Brain and Nerve, vol. 56, no. 12, pp. 1029-1034.
Fushimi, Soichiro ; Nagano, Isao ; Deguchi, Kentaro ; Nagotani, Shoko ; Murakami, Tetsuro ; Shoji, Mikio ; Abe, Koji. / A case of subacute myelitis associated with primary Sjögren syndrome showing no MRI abnormality and diagnosed by somatosensory evoked potentials. In: Brain and Nerve. 2004 ; Vol. 56, No. 12. pp. 1029-1034.
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