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To: Journal of PRACTICAL NEUROLOGY Letters

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Neurological pictures: T Yamamoto, S Ito, and T Hattori Acute longitudinal myelitis as the initial manifestation of Sjögren’s syndrome J Neurol Neurosurg Psychiatry 2006; 77: 780 [Full text] [PDF]

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Acute myelitis or anterior spinal artery occlusion?

Nicola Latronico   (23 May 2006)

Acute myelitis or anterior spinal artery occlusion? 23 May 2006
Nicola Latronico, MD University of Brescia, Italy Send letter to journal: Re: Acute myelitis or anterior spinal artery occlusion? latronic{at}med.unibs.it Nicola Latronico	Dear Editor, I read with interest the case report by Yamamoto and colleagues on acute onset paraplegia in a young woman, which was interpreted as a case of acute longitudinal myelitis (1). Sudden onset without any inflammatory prodromal symptom or sign is evocative of arterial occlusion, and the MRI may be compatible with anterior spinal artery occlusion (2). Although lancinating radicular pain was absent, I wonder whether the authors investigated this diagnosis, as prompt intravenous heparin treatment can be resolutive in such cases. Procoagulant states in young women are not rare, pregnancy and the postpartum, the contraceptive pill may play a role. References 1)Yamamoto T, Ito S, Hattori T. Acute longitudinal myelitis as the initial manifestation of Sjo�gren�s syndrome. J Neurol Neurosurg Psychiatry 2006;77:780. 2) Latronico N, Fassini P, Antonini B, Gasparotti R. A pain in the neck. Lancet 2002; 359: 1206.