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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



NMD, locked-in


Medicine and Health Sciences | Rehabilitation and Therapy


Presented at the 2020 Association of Academic Physiatrists Annual Meeting

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