Published in:
01-06-2017 | Neuro-Images
Paraplegia related to solitary lesion of the cervicomedullary junction
Published in: Acta Neurologica Belgica | Issue 2/2017
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A 40-year-old man without medical history developed within 14 years a spastic paraplegia. Besides spastic paraplegia with brisk lower limb reflexes and bilateral Babinski sign, clinical examination was normal. Brain MRI showed a single non-enhanced lesion involving the ventral cervicomedullary junction (Fig. 1), and spinal cord MRI was normal. Cerebrospinal fluid analysis showed oligoclonal bands not detectable in the matched serum. Metabolic, infectious, and immunological screening, including aquaporin-4 and myelin oligodendrocyte glycoprotein antibodies, were unremarkable. Since extensive investigations remained negative, the diagnosis of solitary sclerosis was made.
Fig. 1
Solitary demyelinating lesion at the cervicomedullary junction. Sagittal (a) and axial (b) T2-weighted images showing lesion at the cervicomedullary junction (arrowheads). c Showing the pyramidal tract decussation. Circle, rhombus, and square indicate the well-described lesions of the cervicomedullary junction (arrows) leading, respectively, to brachial diplegia (i.e., cruciate paralysis), hemiplegia cruciata, and, as in our patient, paraplegia
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