Patient 1 | Patient 2 | Patient 3 | |
Age at onset/sex | 15/Male | 22/Female | 73/Female |
Serum total IgE (U/ml) | 1300 | 298 | 306 |
Eosinophil (%) | 8% | 6.5% | 8.7% |
Interval between asthma attack and onset of myelitis (days) | 6 | 7 (1') and 9 (2')1-150 | 2 |
Symptoms and signs during illness: | |||
Motor weakness | + (mono) | + (mono) | + (mono) |
Muscle atrophy | + | + | + |
Increased tendon reflex | − | + (2') | + |
Sensory signs | − | + | − |
Sphincter disturbance | − | − | − |
Clinically estimated main lesions | LS | LS (1'), C (2') | C |
EDSS | 3 | 3.5 | 3 |
Spinal cord MRI | − | + (C, 2') | − |
Needle EMG | Neurogenic changes | Neurogenic changes | Neurogenic changes |
(myotomes)1-151 | (lt L2-S1, rt L2-L4) | (rt L2-S2) | (rt C5-T1) |
CSF: | |||
Pleocytosis (>5/μl) | 7 | 1 | 1 |
Increased protein (>45 mg/dl) | 54 | 52 | 40 |
Clinical course | Unimproved | Slightly improved | Unimproved |
↵1-150 Patient 2 had a second asthma attack during the corticosteroid therapy and 9 days later she developed another episode of monoparesis.
1'=the first episode; 2'=the second episode.
C=Cervical; T=thoracic; LS=lumbosacral; mono=monoparesis; EDSS=Kurtzke's expanded disability status scale.16
↵1-151 Myotomes showing neurogenic changes on needle EMG; lt=left; rt=right.