case_images: PMC8119990_01
case_images: MRI progression: at time of diagnosis (A1-4), 3 days after last dose of p.o. MP (B) and 11 days after last dose of p.o. MP (C). (A1) Sagittal T2-weighted MRI of columna totalis showing extensive LETM at cervical and thoracic levels. (A2) Sagittal T1-weighted MRI of columna totalis with contrast showing contrast enhancement at levels Th5-Th9. (A3) Sagittal T1-weighted MRI with contrast showing enhancement from C4-Th1. (A4) Axial T1-weighted MRI with contrast showing anterolateral multifocal contrast enhancement at level Th9. (B) Sagittal T2-weighted MRI of columna totalis showing almost complete regression of LETM. No contrast enhancement on T1 (not shown). (C) Sagittal T2-weighted MRI of columna totalis with relapsing LETM on levels Th5-Th11. Contrast enhancement on T1 weighted MRI (not shown).
case_images: fneur-12-655283-g0001.jpg
case_images: PMC8119990_01_fneur-12-655283-g0001.jpg
case_images: F1
case_images: While an MRI of the cerebrum showed no signs of pathology, a repeat MRI of the spinal column with contrast confirmed LETM (Figure 1A).
case_images: Indirect immunofluorescence assay on primate cerebellar and intestinal sections. (A,B) Granular cytoplasmic and dendritic fluorescence of Purkinje cells and a granular fluorescence of the molecular and granular cerebellar layers. (A) Sera in dilution 1:100, (B) undiluted CSF. (C) Granular cytoplasmic fluorescens of neurons in the intestinal plexus myentericus. Undiluted CSF.
case_images: fneur-12-655283-g0002.jpg
case_images: PMC8119990_01_fneur-12-655283-g0002.jpg
case_images: F2
case_images: LETM remitted during treatment and MRI confirmed LETM regression (Figure 2B). CT showed signs of paralytic ileus and an MRI showed relapsing LETM (Figure 2C).
case_images: Timeline with selected events and data. p.o., oral; i.v., intravenous; MRI, magnetic resonance imaging; CSF, cerebrospinal fluid; IFA, indirect immunofluorescence assay; MP, methylprednisolone; PEX, plasmapheresis; CT, computer tomography; GI, gastrointestinal.
case_images: fneur-12-655283-g0003.jpg
case_images: PMC8119990_01_fneur-12-655283-g0003.jpg
case_images: F3
case_images: An overview of the timeline is illustrated in Figure 3.