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Parainfectious Brown-Sequard syndrome associated with Mycoplasma pneumoniae in an adult patient: a case report

Spinal Cord Series and Cases volume 10, Article number: 13 (2024) Cite this article

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Abstract

Introduction

Acute transverse myelitis (ATM) refers to a rare severe acquired spinal cord inflammation, with a challenging diagnostic work-up and treatment.

Case presentation

We report the case of a 42-year-old patient who presented with loss of temperature and pain sensation beneath the C5 dermatome in her left side and reported a history of a possible respiratory tract illness 10 days ago. Within 2 days, clinical worsening was noted, compatible with Brown-Sequard syndrome. Spinal magnetic resonance imaging revealed a T2 sequence abnormal signal from level C4 to T3 and cerebrospinal fluid (CSF) studies showed only a mild pleocytosis mononuclear type. Extensive CSF and blood tests revealed only high Mycoplasma pneumoniae IgM and IgG titers. Treatment with high-dose intravenous methylprednisolone and oral azithromycin were administrated and the patient recovered completely within two months.

Discussion

We would like to highlight the importance for physicians to consider M. pneumoniae in their differential diagnosis as a potential cause when encountering patients with symptoms of ATM and inflammatory Brown-Sequard syndrome.

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Fig. 1: Spinal magnetic resonance imaging showing an abnormal signal lesion from C4 to T3 level.
Fig. 2

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Further anonymized data can be made available to qualified investigators upon request to the corresponding author.

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Acknowledgements

We would like to thank our patient for his permission to publish this paper and Dr. Kanavouras Konstantinos for helpful discussion on the manuscript.

Funding

There are no funding sources to be declared.

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Authors and Affiliations

  1. Department of Neurology, G. Gennimatas General Hospital of Athens, Athens, Greece

    Michail Papantoniou, Konstantinos – Vasileios Tsatinas & Maria Gryllia

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  1. Michail Papantoniou
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  2. Konstantinos – Vasileios Tsatinas
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  3. Maria Gryllia
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Contributions

MP: clinical course, wrote the manuscript, TKV: clinical course, MG: clinical course.

Corresponding author

Correspondence to Michail Papantoniou.

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Competing interests

The authors decalre no competing interests.

Ethical approval

This study was approved by the Scientific Committee of G. Gennimatas Hospital.

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Written informed consent was obtained from the patient for publication of this case report and any accompanying images.

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Papantoniou, M., Tsatinas, K.–.V. & Gryllia, M. Parainfectious Brown-Sequard syndrome associated with Mycoplasma pneumoniae in an adult patient: a case report. Spinal Cord Ser Cases 10, 13 (2024). https://doi.org/10.1038/s41394-024-00627-4

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