Rehabilitation for paraplegia caused by neuromyelitis optica: A case report

Abstract

Study design: Single case report. Objective: We present a case of paraplegia due to neuromyelitis optica (NMO) with poor rehabilitation outcome. Setting: University hospital, Japan. Case report: A 27-year-old woman with NMO presented with T5 paraplegia of Asia impairment scale grade A. Spinal cord magnetic resonance imaging revealed a lesion spanning C3 to L1 level. After acute phase treatment, flaccid paraplegia below T5 and a T2-weighted hyperintense lesion from T6 to T10 level remained. Rehabilitation aimed at independence of activities of daily living with wheelchair assistance, including transfer activity, was provided for 19 months. However, flaccid paralysis of the trunk and limbs persisted, and safe independent transfer was not achieved. Conclusion: Spinal lesions spanning many vertebral segments, a characteristic of NMO, can cause extensive flaccid paralysis of the trunk and limbs. Rehabilitation may achieve poorer functional recovery than that for spinal cord injury.