[Acute myelitis with Brown-Séquard syndrome complicated with subjective sudomotor laterality and ileocecal abscess without right abdominal pain].

ABSTRACT

A 47-year-old man presented with left shoulder pain and muscle weakness in the left limbs on November 2017. On the next day, he experienced dysesthesia of the right limbs and hypohidrosis of the left limbs and developed thermal hypoalgesia in right side of body and muscle weakness of the left upper and lower limbs progressed. He was diagnosed with acute myelitis and Brown-Séquard syndrome, based on cervical MRI scan. Muscle strength improved after steroid therapy and plasma exchange. He experienced complications of intraabdominal abscess in the right side during immunological therapy, although he only had a symptom of left abdominal pain, without pain in the right side. It is noteworthy that abdominal hypoalgesia can be associated with Brown-Séquard syndrome. Characteristically, MRI revealed bilateral lesions at the C3/4 cervical spine level. This report shows that in Brown-Séquard syndrome associated with bilateral spinal lesions, the abdominal visceral sensory pathway, in addition to the somatosensory pathway, could be impaired bilaterally, resulting in aggravation of abdominal hypoalgesia.