[A case of radiation myelopathy with characteristic findings of thermoregulatory sweat distribution and magnetic resonance images].
A 73-year-old man had undergone resection of a lung carcinoma of the right upper lobe in 1987. Post-operative irradiation (40 Gy) was given to the right hilus. In November 1988, recurrence was detected in the trachea. Laser therapy was done in December 1988. From January 9 to February 13 in 1989, irradiation (50 Gy) was given to the mediastinum. From the beginning of 1991, the patient developed muscle weakness in the right lower extremity and pain temperature sensations were impaired below the Th12 level on the left side. On October 3, 1991, he was admitted to our hospital. Neurological examination revealed mild muscle weakness in the right lower extremity. Superficial sensations were impaired below the Th6 level bilaterally. Deep tendon reflexes were hyperactive in the lower extremities. A bilateral Babinski sign was positive. The T1 weighted MRI showed a low signal intensity in the spinal cord at the level of thoracic vertebra (TV)2-TV6. T2 weighted images revealed a high signal intensity area of the spinal cord from TV4-TV6. A gadolinium-DTPA injection revealed an enhancement on the left side of the spinal cord at the TV2-3 level, and right side of the spinal cord at the TV4-5 level on the sagittal and axial images. A thermal sweating test revealed hypohidrosis below the Th8 level on the right side, and the Th11 level on the left side. Sweating was delayed at the Th7-8 levels on the right side and Th10-11 levels on the left side. An irradiated field on the chest revealed hypohidrosis.(ABSTRACT TRUNCATED AT 250 WORDS)
Goto
K
K
Third Department of Internal Medicine, Oita Medical University.
Sannomiya
K
K
Nagao
S
S
Nakazato
O
O
Tsuda
T
T
D000368:Aged; D001833:Body Temperature Regulation; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D011832:Radiation Injuries / Q000175:diagnosis / Q000209:etiology*; D011878:Radiotherapy / Q000009:adverse effects; D013118:Spinal Cord Diseases / Q000175:diagnosis / Q000209:etiology*; D013546:Sweating