neurology-2018-posters-abstracts

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Journal of Neurology and Neurorehabilitation Research | Volume 3

August 23-24, 2018 | Paris, France

Neurology and Neurological Disorders

International Conference on

An Iatrogenic Lhermitte’s sign as a presenting feature of transverse myelitis: “A rare case of prolong full

bloomdisease course of NMO spectrumdisorders (NMOSD) under PRF (Pulsed Radiofrequency) treatment

Chao-nan Yang

China Medical University, Taiwan

case of 53-year-old female patient with insidiously

feet numbness initially, with progressive ascending

numbness and mild to moderate weakness of lower

limbs reaching maximum impairment for 2months. Initial

examination found decreased DTR on bilateral ankle reflex

without weakness. It takes about 2 months to the nadir,

very slow progressive ascending weakness and paresthesia.

She takes rehabilitation for 2 months. She received PRF

(Pulsed Radiofrequency) therapy 1 months later after

symptom onset. Under the impression of mild L4/L5 HIVD

and radiculopathy by neurosurgery doctor. With 42°C

electrode stimulation in bilateral L5 DRG (dorsal root

ganglion). She developed sudden whole back area electric

shock-like sensation with radiation to 4 limbs soon after PRF

stimulation and lasting the symptom when movement the

back or neck after that for 3-4weeks. And slowly relieved later.

DTR was increased 2months later when she came

to our neurologic clinic and she walk by stick.

The spinal cord MRI revealed along, extended spinal cord

lesion from T9-T11. The VEP (Visual evoked potential)

showed prolonged latencies bilaterally without any eye

symptom. Further Brain MRI showed lesion at right middle

cerebellar peduncular. Lab data was no remarkable. CSF

study showed no active inflammation or infection. IgG

index: 0.54, blood test for AQP4 Ab showed positive.

Lhermitte’s sign (LS) is one of the sensory symptoms of the

spinal cord that is frequent seen in NMOSD. But was rare

under Pulsed Radiofrequency situation. Physician should

be aware the disease course and should always put spinal

cord lesion into consideration before invasive procedure.