Background of recent marathon running and short-haul flight. The patient reported sudden onset pain in the posterior aspect of her left shoulder, followed by pain and paresthesia in her entire left arm followed by left leg. After few minutes, she experienced weakness on the left side of her body, with the right side following and then after a few hours she was quadriplegic. 3/10 severity neck pain. On initial examination, she was alert and oriented with no cognitive impairment or cranial nerve deficit. Her voice was weak, coughing was ineffective and she had mild difficulty breathing. Muscle strength was 0/5 in all limbs. Sensation was globally reduced, but pain and temperature sense was more preserved on the left while vibration and proprioception was more preserved on the right. Deep tendon reflexes were absent throughout except for +2 right knee jerk. Plantar reflex was absent bilaterally. CT scan & MRI brain was performed soon which returned normal. CSF analysis was within normal limits. T2-weighted MRI cervical spine done 6 hours after initial symptoms revealed minimally increased T2 signal in the central grey matter at the level of C5-C6-C7. Repeat MRI cervical spine was done 3 days later.
Patient Data
| Age: | 17 years |
|---|---|
| Gender: | Female |