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Administered by: Unknown Purchased by: Unknown
Life Threatening? No
Write-up: This literature report (initial receipt: 13-Nov-2012) concerns a 49-year-old male patient. The patient had a recent history of viral infection status post flu vaccination (manufacturer, brand name and batch number were not provided). On an unknown date (post viral infection) the patient presented with a 2-week history of bilateral lower extremity weakness and paresthesias starting at the level of the axilla. He was evaluated by Neurology and initially diagnosed with transverse myelitis. He underwent intravenous immunoglobulin and steroid treatment without improvement. The patient''s physical examination revealed 3/5 proximal and 5/5 distal muscle strength in the lower extremities, deep tendon reflexes were 2/4 with no upper motor neuron signs visualized. He was medically stabilized and transferred to inpatient rehabilitation facility. Ten days post admission, the patient experienced acute motor loss (0/5) in bilateral lower extremities and worsening paresthesias, now involving bilateral upper extremities. At 10 days post admission, imaging revealed C7 to T2 diffuse cord expansion and an oval-shaped focus of intramedullary enhancement. Prior to the completion of his medical work-up, the patient passed away due to unclear causes. Death was most likely related to respiratory compromise. Post mortem autopsy results showed histopathological diagnosis of primary glioblastoma multiforme of the spinal cord. Reporter''s comment: This is a rare documented case of primary spinal glioblastoma multiforme in an adult patient. Mean survival time after onset is between 6-16 months. The major cause of death is leptomeningeal spread and cerebral metastasis. Cervical glioblastoma multiforme may have an even poorer outcome because of early involvement of the phrenic nerve nucleus and vasomotor centers.
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