Locked-In Syndrome Due to Neuromyelitis Optica Spectrum Disorder in Acute Rehabilitation: A Case Report

Authors

James J. Bresnahan, MD, Thomas Jefferson UniversityFollow
Summer Schultz, MD, Thomas Jefferson UniversityFollow
Mithra B. Maneyapanda, MD, Thomas Jefferson University; Bryn Mawr Rehabilitation HospitalFollow

Files

Description

Case Description

• 56-year-old female patient with prior questionable diagnoses of brainstem infarct, multiple sclerosis, and systemic lupus erythematosus who presented to the hospital with progressive dysarthria, lethargy, and weakness.
• MRI noted bilateral demyelinating lesions of the midbrain, pons, and middle cerebellar peduncles as well as nonspecific signal abnormality in the spinal cord at T6-T7.
• Her condition further deteriorated to flaccid complete tetraplegia. Communication was limited to extraocular movements and eye blinking.
• Serum aquaporin-4 antibody assay was positive.
• She was diagnosed with NMOSD resulting in transverse myelitis and locked-in syndrome.
• She was treated with IVIG and high-dose steroids and eventually plasma exchange.
• She completed 76 days of acute rehabilitation with a 3-day absence for rituximab infusions.

Publication Date

3-7-2020

Keywords

NMD, locked-in

Disciplines

Medicine and Health Sciences | Rehabilitation and Therapy

Comments

Presented at the 2020 Association of Academic Physiatrists Annual Meeting

Recommended Citation

Bresnahan, MD, James J.; Schultz, MD, Summer; and Maneyapanda, MD, Mithra B., "Locked-In Syndrome Due to Neuromyelitis Optica Spectrum Disorder in Acute Rehabilitation: A Case Report" (2020). Department of Rehabilitation Medicine Posters. 10.
https://jdc.jefferson.edu/rmposters/10