Postherpetic multifocal long-segment myelitis responsive to intravenous immunoglobulin and steroid therapy

Acute disseminated myelitis (ADM) may occur following a viral infection or vaccination. We herein report a 31-year-old lady who develop an acute rapidly progressive paraplegia and atonic bladder associated with seroconversion of herpes simplex virus type 2. Magnetic resonance imaging (MRI) of the spinal cord shows multifocal long-segment myelopathy involving the cervical cord from C2 segment to thoracic cord T2 segment, and the lumbosacral cord at the conus medullaris. She had partial clinical response to intravenous dexamethasone. Intravenous immunoglobulin yielded a dramatic clinical improvement. The patient was ambulatory without any voiding difficulty 3 months after the onset. Findings on follow-up MRI correlated to her clinical improvements.