title: Cardiovascular impairment in a patient with acute myelitis.
abstract: METHODS
  Case report.
  
  
  OBJECTIVE
  to report and discuss the development of sudden symptomatic sinus bradycardia in a 35-year-old woman with acute myelitis.
  
  
  METHODS
  A 35-year-old woman presented rapidly progressive weakness and hypoesthesia in the left hemibody. Five days after symptom onset, she developed symptomatic sinus bradycardia up to 30 b.p.m. Bradycardia was completely resolved ∼36 h after its onset.
  
  
  RESULTS
  Cervical spine magnetic resonance imaging showed a focal T2-hyperintense intramedullary lesion at C2 level, with moderate cord swelling. The lesion involved bilaterally dorsal funiculi, and left lateral and ventral funiculi. Cardiac I-123 metaiodobenzylguanidine (MIBG) scintigraphy showed a decreased cardiac MIBG uptake suggesting sympathetic denervation.
  
  
  CONCLUSIONS
  The most likely explanation for bradycardia in our patient is the myelitis-related disruption of descending vasomotor pathways, resulting in sympathetic hypoactivity. Our case extends the spectrum of the clinical presentations of cervical myelitis and emphasizes the importance of careful cardiac monitoring in acute phase of cervical myelitis.
authors.affiliation: Institute of Neurology, Rome, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Profice
authors.forename: R
authors.initials: R
authors.lastname: Renna
authors.forename: F
authors.initials: F
authors.lastname: Pilato
authors.forename: A
authors.initials: A
authors.lastname: Sestito
authors.forename: F
authors.initials: F
authors.lastname: Infusino
authors.forename: I
authors.initials: I
authors.lastname: Bruno
authors.forename: E
authors.initials: E
authors.lastname: Pravatà
authors.forename: V
authors.initials: V
authors.lastname: Di Lazzaro
mesh_terms: D000328:Adult; D001146:Arrhythmia, Sinus / Q000000981:diagnostic imaging / Q000209:etiology; D001919:Bradycardia / Q000000981:diagnostic imaging / Q000209:etiology*; D005260:Female; D015637:Gated Blood-Pool Imaging; D006801:Humans; D009188:Myelitis, Transverse / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology*