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Rehabilitation Practice and Science

Translated Title

全身性紅斑性狼瘡併發大範圍脊髓侵犯之急性橫斷性脊髓炎：病例報告

Abstract

Acute transverse myelitis ( ATM ) is a rare but severe complication of systemic lupus erythema-tosus ( SLE ). Magnetic resonance imaging ( MRI ) is the leading imaging study for diagnosing ATM and monitoring the treatment and/or the progression of the disease. Lesions of the spinal cord of ATM are usually less than 4 spinal segments. Currently, high dose corticosteroid plus cytotoxic agents is recommended to obtain the maximal therapeutic efficacy.A case of lupus-related ATM with diffuse spinal cord involvement is presented. A 21-year-old woman had a 4-year history of SLE. Acute onset of weakness and numbness of bilateral lower limbs were found since July 1, 2000. Neurological examination was suggestive of thoracic spinal cord lesion with signs of both upper and lower motor neuron disorders. MRI of the spine revealed cord swelling and hypersignal lesions with diffuse involvement from T3 to conus medullaris on T2 weighted images. Lupus-related ATM was diagnosed and two courses of pulse corticosteroid therapy and one course of pulse cytotoxic agent therapy were given. She was transferred to our rehabilitation unit 18 days after onset of ATM. With participation in a comprehensive rehabilitation program for 2 months, she experienced marked improvement in clinic symptoms, motor functions, bladder functions and independence in her activities of daily living. The muscle power of bilateral lower limbs improved from grade 2 to grade 4-5. She could walk with a quad cane independently. We concluded that early aggressive therapy with high dose corticosteroid plus cytotoxic agents and a comprehensive rehabilitation program should be prescribed for patients with lupus-related ATM.

Language

Traditional Chinese

First Page

153

Last Page

158

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