Demyelinating vs Vascular Disease

by

Sergio Kosac, M.D.

A 52 year old male with a 50 day history of paraparesis, mainly of the right side.  He is recovering slowly.
Exam: Initially patient had motor compromise of all 4 limbs but mainly his lower.  He is now having almost total recovery of his upper limbs.  He has no cranial nerve findings except for a possible mild right facial nerve paresis.  He has no sensory signs in lower limbs.
Pending studies include evoked potentials, CSF, and electrophoretic analysis.
EMG showed low CMAP amplitude, mainly in proximal muscles (Vastus ), slowering of CV, (43 m/seg Peroneal), moderate amount of polyphasics.

Below are this patients MRI studies.

MRI Scan

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Updated 8/28/2010

(c) 2010 M. H. Rivner