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A woman with acute myelopathy in pregnancy: case progression

BMJ 2009; 339 doi: (Published 19 November 2009) Cite this as: BMJ 2009;339:b4025
  1. Reinhard Reuß, physician 1,
  2. Paulus S Rommer, researcher 1,
  3. Wolfgang Brück, professor2,
  4. Friedemann Paul, head of research group 39,
  5. Michael Bolz, senior physician4,
  6. Sven Jarius, neuroimmunologist5,
  7. Tobias Boettcher, clinical neurologist6,
  8. Annette Großmann, senior physician7,
  9. Alexander Bock, senior physician8,
  10. Frauke Zipp, professor9,
  11. Reiner Benecke, professor1,
  12. Uwe K Zettl, professor1
  1. 1Department of Neurology, University of Rostock, 18147 Rostock, Germany
  2. 2Institute of Neuropathology, University Medical Center Göttingen, Göttingen, Germany
  3. 3NeuroCure Clinical Research Center, Charité Universitätsmedizin Berlin, Berlin, Germany
  4. 4Department of Gynaecology, University of Rostock
  5. 5Division of Molecular Neuroimmunology, Department of Neurology, University of Heidelberg, Heidelberg, Germany
  6. 6Neurology Division, Dietrich-Bonhoeffer Klinikum Neubrandenburg, Neubrandenburg, Germany
  7. 7Department of Radiology, University of Rostock
  8. 8Neuroradiology Division, Dietrich-Bonhoeffer Klinikum Neubrandenburg
  9. 9Cecilie-Vogt Clinic for Neurology, Charité-Universitätsmedizin Berlin
  1. Correspondence to: R Reuß reinhard.reuss{at}
  • Accepted 14 August 2009

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 …

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