Teaching neuro image: Cervical cord atrophy with dorsal root ganglionopathy in sjögren syndrome
Journal
Neurology
Journal Volume
70
Journal Issue
7
Pages
e27
Date Issued
2008
Author(s)
Lin C.-C.
Abstract
A 59-year-old woman had had asymmetric numbness from her neck to both arms and left leg for 5 years. She had had dry eyes and mouth for many years. Examination showed sensory ataxia, generalized areflexia, positive Romberg test, and hand pseudoathetosis. Vibration sense was reduced in both lower limbs; the severity was more on the left side but was not length dependent. Joint position sense was impaired in all limbs while pain and temperature senses were comparatively preserved. No sensory level was demarcated. Electrophysiologic studies revealed absence of sensory action potentials in all sampled nerves and prolonged central conduction time from median nerves on somatosensoryevoked potentials. 1,2 Her anti-SSA antibody, rheumatoid factor, and Schirmer test were positive. MRI (figure) showed cervical cord atrophy with increased T2 signal intensity at the dorsal column which implied a consequence of centripetal Wallerian degeneration from dorsal root ganglionopathy in a patient with Sjo gren syndrome.
Type
note