title: Episodic spastic paraparesis successfully treated with unaided blood transfusions: a case report.
abstract: BACKGROUND
  Extramedullary haemopoiesis is a common compensatory phenomenon in most haemolytic anaemias. However, spinal cord compression due to extramedullary spinal epidural haemopoiesis is an extremely rare complication of thalassemia. In such situation patients present with paraplegia with a sensory level. Usual treatment options are surgery and/or radiotherapy.
  
  
  METHODS
  Here we report a 27 year old Sri Lankan Muslim male with haemoglobin E-Beta thalassaemia presented with episodic spastic paraparesis when he was anaemic which was dramatically responded to blood transfusion therapy.
  
  
  CONCLUSIONS
  Most of the reported cases with paraplegia have been treated with surgery with or without radiation therapy or radiation therapy alone. Our patient makes dramatic recovery after blood transfusion in each presentation.
authors.affiliation: Department of Medicine, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka. manojipathi@yahoo.com.
authors.forename: Loku Pathirage Manoji Muditha Kumari
authors.initials: LP
authors.lastname: Pathirage
authors.affiliation: Neurology Unit, General Hospital - Kandy, Kandy, Sri Lanka. iwijeweera@yahoo.com.
authors.forename: Indunil
authors.initials: I
authors.lastname: Wijeweera
authors.affiliation: Department of Medicine, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka. jayasinghe_chandrika@yahoo.co.uk.
authors.forename: Chandrika
authors.initials: C
authors.lastname: Jayasinghe
authors.affiliation: Department of Radiology, Teaching Hospital - Peradeniya, Peradeniya, Sri Lanka. saumya614@yahoo.com.
authors.forename: Saumya
authors.initials: S
authors.lastname: Jayabahu
authors.affiliation: Department of Medicine, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka. hasith.wicky@gmail.com.
authors.forename: Hasith Ravinda
authors.initials: HR
authors.lastname: Wickramasinghe
mesh_terms: D000328:Adult; D001803:Blood Transfusion; D004824:Epidural Space / Q000473:pathology; D006801:Humans; D008297:Male; D020336:Paraparesis, Spastic / Q000150:complications / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*; D013117:Spinal Cord Compression / Q000150:complications / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*; D016896:Treatment Outcome; D017086:beta-Thalassemia / Q000150:complications / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*