Case of May 2010

Clinical History:

A 15 years-old girl was presented with progressive lower limb weakness for 1 week. The lower limb weakness was preceded by repeated vomiting for few days. On physical examination, there was diminished deep tendon reflex of bilateral lower limbs. Bilateral lower limb power was 4/5. She was afebrile and not septic. CSF analysis revealed elevated CSF protein level with normal cell count and negative gram staining. An urgent MRI brain and whole spine was performed. Selected images of the MRI lumbar spine were illustrated.

                            Fig. 1 T1 Axial                                                            Fig. 2 T2 Axial

                        Fig. 3 T1+C FS Axial                                                    Fig. 4 T1 Sagittal

                           Fig. 5 T2 Sagittal                                                Fig. 6 T1+C FS Sagittal