TY - JOUR T1 - Devic type multiple sclerosis in an 81 year old woman JF - Journal of Neurology, Neurosurgery & Psychiatry JO - J Neurol Neurosurg Psychiatry SP - 417 LP - 418 DO - 10.1136/jnnp.64.3.417 VL - 64 IS - 3 AU - S M STAUGAITIS AU - J K ROBERTS AU - R L SACCO AU - J R MILLER AU - A J DWORK Y1 - 1998/03/01 UR - http://jnnp.bmj.com/content/64/3/417.abstract N2 - An 81 year old woman presented after several transient episodes of dizziness and nausea. One episode was associated with right arm dysmetria. She denied previous neurological symptoms. Her medical history was relevant for myocardial infarction, two coronary artery bypass grafts, and Hashimoto’s thyroiditis. Brain MRI showed abnormal signal intensities which were attributed to cerebrovascular disease and she was treated with ticlopidine. Several months later, she had an influenza vaccination and one month afterwards she developed bilateral foot weakness and numbness. These symptoms progressed over three days to complete paraplegia, a thoracic sensory level, and urinary incontinence. No abnormalities were seen in the spinal cord on MRI. Over the next two months, sensation and bladder control improved and she could walk with a frame. Six months later, her spinal cord symptoms recurred; MRI at this time showed a cavitary lesion that extended from T2 to T10 with peripheral enhancement. Brain MRI showed multiple abnormal white matter signal intensities.Cerebrospinal fluid contained 10 leucocytes/mm3 (70% lymphocytes, 20% monocytes, 10% polymorphonuclear leucocytes), total protein was 100 mg/dl, IgG/total protein was 16%, and oligoclonal bands were more intense in CSF than in serum. Complete blood count, chemistry profile, thyroid function tests, erythrocyte … ER -