Spinal Cord Infarction with Markedly Elevated Protein in CSF Mimicking Inflammatory Disease

Case Report

Austin J Clin Neurol 2017; 4(3): 1112.

Spinal Cord Infarction with Markedly Elevated Protein in CSF Mimicking Inflammatory Disease

Sriwastava S*, Nandanwar D and Navid Seraji- Bozorgzad

Department of Neurology, Detroit Medical Center, Wayne State University, USA

*Corresponding author: Shitiz Sriwastava, Department of Neurology, Detroit Medical Center, Wayne State University, 4201 St. Antoine st UHC 8A, Detroit Michigan 48102, USA

Received: May 07, 2017; Accepted: June 15, 2017; Published: June 29, 2017

Abstract

Spinal cord infarction following cardiac surgery from hypoperfusion is one of the mechanisms for cord infarction. It can mimic NMO because of extensive cord involvement and acute presentation.

Keywords: Spinal cord infarction post CABG; Neuromyelitis optica

Case Presentation

Information pertaining to the case was obtained via retrospective review of electronic medical records.

51 year lady with HTN, HLD, TIA, DM, multi vessel CAD s/p CABG on 6/20/16 followed by spinal infarct with resultant paraplegia and bowel bladder incontinence was transferred from Rehabilitation to ED with complaints of chest tightness across her entire chest. Pt denies having SOB and Pts chest pain resolved on its own. Neurology was consulted due to her paraplegia [1-4].

Neurological examination, there is a sensory level at T5 level. Patellar and Achilles reflexes absent, plantar response is mute bilaterally.

Investigation

Patient was evaluated with extensive work up for inflammatory cause.

Spinal tap showed 27 nucleated cell, lymphocyte 69% and 24 monocytes.

Protein 460, glucose 90, oligoclonal bands CSF 0, serum oligoclonal 2, VDRL CSF non reactive, no malignant cell seen. Serum NMO was negative WNV, EBV and VZV PCR, HSV 1 & 2 not detected. HIV AG/AB combo non reactive, hepatitis panel negative Mycobacterium TB PCR not detected. ENA, anti dsDNA non detected, ANA weakly postive1:80 speckled pattern.

Citation: Sriwastava S, Nandanwar D and Seraji-Bozorgzad N. Spinal Cord Infarction with Markedly Elevated Protein in CSF Mimicking Inflammatory Disease. Austin J Clin Neurol 2017; 4(3): 1112. ISSN:2381-9154