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Gadolinium enhancement in cervical dorsal roots in a patient with acute autonomic and sensory neuropathy: a case report

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Author(s)
Du Hwan KimJang Hyuk ChoMathieu Boudier-RevéretMin Cheol Chang
Keimyung Author(s)
Cho, Jang Hyuk
Department
Dept. of Rehabilitation Medicine (재활의학)
Journal Title
BMC Neurol
Issued Date
2023
Volume
23
Issue
1
Keyword
Acute autonomic and sensory neuropathyDiagnosisMagnetic resonance imaging
Abstract
Background:
We report an enhancement of the dorsal roots on gadolinium-enhanced cervical magnetic resonance imaging (MRI) in a patient with acute autonomic and sensory neuropathy (AASN).

Case presentation:
A 38-year-old woman visited our university hospital for dizziness and fainting while rising from sitting or lying down and a tingling sensation in the whole body, including her limbs, torso, and abdomen, which was sustained for 15 days. The patient had hyperalgesia in nearly her entire body and slight motor weakness in her bilateral upper and lower limbs. Autonomic dysfunction was confirmed using autonomic testing. Furthermore, the nerve conduction study showed an absence of sensory nerve action potentials in all evaluated peripheral nerves. Cervical MRI was performed 18 days after dysautonomia onset. In the axial T1-gadolinum-enhanced MRIs, enhancement in cervical ventral and dorsal nerve roots and the posterior column of the spinal cord were observed, and the axial T2-weighted MRI showed high signal intensity in the posterior column of the cervical spinal cord. Considering the clinical, electrophysiological and imaging findings, the patient was diagnosed with AASN. A total dose of 90 g (2 g/kg) of intravenous immunoglobulin was administered over 5 days. At the follow-up at 4 years after AASN symptom onset, the hyperalgesia and orthostatic hypotension symptoms improved. However, her systolic blood pressure intermittently decreased to < 80 mmHg.

Conclusion:
Gadolinium-enhanced MRI may facilitate the accurate and prompt diagnosis of AASN.
Keimyung Author(s)(Kor)
조장혁
Publisher
School of Medicine (의과대학)
Type
Article
ISSN
1471-2377
Source
https://bmcneurol.biomedcentral.com/articles/10.1186/s12883-023-03186-7
DOI
10.1186/s12883-023-03186-7
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/44952
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Rehabilitation Medicine (재활의학)
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