PMC9161094_01
Magnetic resonance imaging of the cervical (A) and thoracic (B) spinal cord. Sagittal T2-weighted imaging showed longitudinally extensive hyperintense lesion extending from C2 to T8.
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Spinal MRI demonstrated longitudinally extensive T2 hyperintensities from C2 to T8 without enhancement ( Figure 1 ).
Timeline depicting muscle strength change, immunotherapy, and cerebrospinal fluid analysis of the patient. For further details, refer to the main text. LP, lumbar puncture.
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Initial lumbar puncture revealed a CSF opening pressure of 140 mmH2O, a WBC count of 120/microl (93% lymphocytes), a protein level of 48 mg/dl, and a normal glucose level ( Figure 2 ). The patient was then treated with intravenous methylprednisolone (500 mg/day for 5 days, followed by a tapering scheme) combined with plasma exchange (5 cycles, every other day) and intravenous immunoglobulin (0.4 g/kg per day for 5 days) ( Figure 2 ).