A 19-year-old man presents with acute paraplegia and loss of pain/temperature sensation at the T10 level; vibration sense is preserved. Vital signs: BP 118/76, HR 88, RR 16, Temp 37.2°C, SpO2 98% on room air. Spinal MRI demonstrates extensive T2 hyperintensity spanning T4-T12 with central cord predominance. CSF analysis shows mild lymphocytic pleocytosis. He denies fever, rash, or recent vaccinations. He takes no medications. Which diagnosis best explains these findings?
- A)Acute transverse myelitisGABARITO
- B)Guillain-Barré syndrome
- C)Syringomyelia from tethered cord
- D)Subacute combined degeneration
- E)Spinal epidural abscess
Explicação
Acute transverse myelitis presents with acute paraplegia, sensory level, and longitudinally extensive myelitis on MRI. The preservation of vibration sense with loss of pain/temperature indicates spinothalamic tract involvement with dorsal column sparing, consi... Ver explicação completa e trilha adaptativa →