Asian Journal of Research and Reports in Neurology

Longitudinal Transverse Myelitis with Locked in Syndrome Revealing a Systemic Lupus Erythematosus

Raja Amri

Internal Medicine Dapartment, Mohamed Taher Maamouri Hospital, Faculty of Medicine of Tunis, University of Tunis El Manar, Nabeul, Tunisia.

Mohamed Othmen Chouchene *

Department of Plastic, Reconstructive, Burn and Hand Surgery, Mohamed Taher Maamouri Hospital, Faculty of Medicine of Tunis, University of Tunis El Manar, Nabeul, Tunisia.

Boutheina Ben Ammou

Internal Medicine Dapartment, Mohamed Taher Maamouri Hospital, Faculty of Medicine of Tunis, University of Tunis El Manar, Nabeul, Tunisia.

Manel Loukil

Department of Pneumology, Mohamed Taher Maamouri Hospital, Faculty of Medicine of Tunis, University of Tunis El Manar, Nabeul, Tunisia.

Mohamed Ali Sbai

Department of Plastic, Reconstructive, Burn and Hand Surgery, Mohamed Taher Maamouri Hospital, Faculty of Medicine of Tunis, University of Tunis El Manar, Nabeul, Tunisia.

*Author to whom correspondence should be addressed.

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Abstract

The neuropsychiatric manifestations of lupus are very heterogeneous and are a source of significant morbidity and mortality. Transverse myelitis is a rare but serious complication of systemic lupus erythematosus, classically described as an acute attack with a poor functional prognosis. It most often complicates the course of a previously diagnosed lupus and corresponds clinically to a complete medullary syndrome associating a symmetrical bilateral sensitivo motor deficit and sphincter disorders. We report a rare case of a young woman who was admitted to intensive care for a rapidly evolving flaccid tetraparesis with impaired consciousness. The explorations concluded that there was lupus with an inaugural neurological disorder such as longitudinal transverse myelitis associated with a secondary locked-in syndrome and a pontine ischemic stroke. Our observation has several particularities: the inaugural character and the longitudinal form of lupus myelitis as well as the serious association at the outset with a locked-in syndrome secondary to a cerebrovascular accident.

Keywords: Systemic lupus erythematosus, myelitis; neurology.

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