Chaonan Yang
Graduate Institute of Integrated Medicine - China Medical University, Taiwan
China Medical University Hospital, Taipei, Taiwan
Scientific Tracks Abstracts: J Neurol Neurophysiol
A case of 53-year-old female patient with insidiously feet numbness initially, with the progressive ascending numbness and mild to moderate weakness of lower limbs reaching the maximum impairment for two months. Initial examination found decreased DTR on bilateral ankle reflex without weakness. It takes about two months to the nadir, very slow progressive ascending weakness and paresthesia. She took rehabilitation for two months and has received PRF (Pulsed Radio Frequency) therapy one month later symptom onset under the impression of mild L4/L5 HIVD and radiculopathy by neurosurgery doctor. With 42�°C electrode stimulation in bilateral L5 DRG (dorsal root ganglion) she has developed sudden electric shock-like sensation in the whole back area with radiation to 4 limbs soon after PRF stimulation, and the symptoms lasted for 3-4 weeks when moving back or neck. And slowly relieved, DTR was increased two months later when she came to our neurologic clinic and she walked with the help of a stick. The spinal cord MRI revealed a long extended spinal cord lesion from T9-T11. The VEP (visual evoked potential) showed prolonged latencies bilaterally without any eye symptom. Further brain MRI showed lesion at right middle cerebellar peduncular. Lab data was not remarkable. CSF study showed no active inflammation or infection. IgG index: 0.54, blood test for AQP4 Ab showed positive. Lhermitteâ��s sign (LS) is one of the sensory symptoms of the spinal cord that is frequently seen in NMOSD. But it was rare under pulsed radiofrequency situation. Physician should be aware of the disease course and should always put spinal cord lesion into consideration before invasive procedure.
Chaonan Yang has completed his Master's degree from Graduate Institute of Integrated Medicine, China Medical University, Taiwan. He is now the attending Physician of Neurology in China Medical University Hospital, Taipei branch.
Email:retsnom2004@yahoo.com.tw
