Case presentation A 14-year-old girl presented with progressive upper and lower extremity weakness. Symptoms started five months prior with intermittent bilateral calf pain along with the onset of lower extremity weakness. Initial evaluation revealed a normal complete blood count, complete metabolic panel, inflammatory markers, and muscle enzymes. Electromyography demonstrated an acute to subacute polyradiculitis affecting the upper and lower extremities. She was admitted for expedited evaluation.
The examination was significant for lower extremity weakness and absent reflexes. Lumbar puncture (LP) showed lymphocytic pleocytosis and markedly elevated protein. Initial examination report CSF Neuromyelitis Optica IgG and paraneoplastic antibody panels were negative. Treatment based on initial examination She was prescribed intravenous immunoglobulin for empiric treatment of chronic…
