A 14 year old boy presents with paraplegia, weakness and loss of sensation in both his lower limbs. His complaints started suddenly and he has no history of fever, seizures or trauma. He also has associated with bowel and bladder dysfunction. Neurological examination reveals weakness and loss of sensations in both lower limbs. Physical examination reveals the presence of large, purplish, macular lesions over his buttocks and anterior thigh. His relatives confirm that these had been present since birth and had been bluish at birth.
He had initially been taken to a local hospital were a lumbar puncture was performed. CSF analysis revealed xanthochromia, cells at 8 lymphocytes/mm3 and elevated proteins. Currently, other investigations including hematology, biochemistry, chest X-ray and ECG were unremarkable. X-ray dorso-lumbar spine was normal. A MRI of the dorsolumbar spine was done.…
