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Magnetic Resonance Indication for Early Anti-inflammatory Treatment?

Arch Neurol. 2004;61:1134-1135.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

In February 1998, a 43-year-old Brazilian man developed a rapidly progressive spastic paraparesis. Cerebrospinal fluid findings showed a mild inflammatory response, with 21 leukocytes/mm³, 240 mg/dL of protein, and an intrathecal immune production of anti–human T-lymphotropic virus 1 (HTLV-1) antibodies. Subsequently, a positive HTLV-1 serological finding was also confirmed. A magnetic resonance (MR) image of the spine revealed thoracic cord edema, along with several foci of contrast-enhanced lesions (Figure 1). The patient was given interferon alfa for 1 month and referred to our center in July 1998. At that point he was wheelchair bound, and results of his neurological examination revealed a flaccid paraparesis, hyporeflexia in the lower limbs, a left Babinski sign, and loss of vibration sense in the legs. In September 1998, a new MR image showed only thoracic cord atrophy with disappearance of all enhanced lesions (Figure 2). At that time, the . . . [Full Text of this Article]

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Marcus Tulius T. Silva, MD, MSc; Abelardo Araújo, MD, PhD