With only two legs numb, the Nam Dinh woman “suddenly” was both blind and paralyzed because of a dangerous disease

That is a female patient (44 years old, from Hai Hoa, Hai Hau, Nam Dinh) admitted to the hospital with the reason of recurrent weakness in the lower extremities, bowel disorders, blurred vision… According to the patient’s family, The disease started 6 months ago with symptoms of numbness in the legs up to the navel, numbness in the pins and needles, gradual weakness in both legs, the patient was taken to the emergency room and treated at the district hospital but did not get better. After that, the patient was transferred to a provincial hospital for further treatment. About 2 weeks later, the patient began to show symptoms of paralysis of both legs, unable to move, blurred vision, urinary retention… and was transferred to E.

At Hospital E, the patient was transferred to the Department of Neurosurgery, where the doctors assigned the necessary tests and scans. After ruling out tumors or trauma, doctors thought the patient had some kind of autoimmune disease causing the damage. Therefore, the doctors conducted a consultation with the doctors of the Department of Allergy, Immunology and Dermatology, and determined that the patient had neuromyelitis optica on the background of systemic lupus erythematosus. The patient was transferred to the Intensive Care Unit and Antitoxicity Department for dialysis and high-dose corticosteroid therapy. After 1 week, the patient improved, was transferred to the Department of Allergy, Immunology and Dermatology to continue treatment according to the protocol of neuromyelitis optica and carry out functional rehabilitation.

Taking the medical history, the patient was diagnosed with lupus erythematosus and neuromyelitis optica 10 years ago but did not receive regular treatment, causing the disease to recur many times. Typically, the disease has caused dangerous complications such as pleural effusion. The patient has been on anti-tuberculosis medicine for 8 months without any improvement. The patient continued to be examined in many large hospitals and was diagnosed with systemic lupus erythematosus. After that, the patient has reduced vision in both eyes and blurred vision of the hand shadow, sometimes no longer seeing objects around. Examination at the Central Eye Hospital, the patient was diagnosed with optic nerve atrophy and was treated stably. Recently, the disease recurred with sudden symptoms of numbness in the legs to the navel, and a feeling of paresthesia. The legs gradually weaken, when walking, need someone to help, then only the tips of the toes can be moved and vision is blurred… New patients come to the hospital for examination and treatment at the medical facilities mentioned above.

MSc.BSNT Nguyen Le Ha – Department of Allergy, Immunology and Dermatology explained: Neuromyelitis opticatritis or neuromyelitis optica spectrum disorders is an autoimmune disease that causes inflammation and demyelinating inflammation of the central nervous system, often damaging the optic nerve. damage to the optic nerve and spinal cord. The disease progresses in stages with many severe sequelae of sensation, movement, vision, and urinary and bowel disorders that accumulate over time, severely affecting quality of life and may cause respiratory failure, dead. During an exacerbation, symptoms peak within a few days, after which only one-third of patients recover completely. This patient was also diagnosed with systemic lupus erythematosus. The combination of neuromyelitis optica and lupus in the same patient is very rare (about 1/5 million people).

The characteristic symptom of optic neuritis is optic neuritis or myelitis. Optic neuritis is inflammation of the optic nerve that causes pain in the eye, pain that increases with eye movement, and often progresses rapidly to vision loss or blindness. Symptoms usually begin in one eye, but can occur in both eyes at the same time or progress from one eye to the other. It is difficult to distinguish optic neuritis in neuromyelitis optica from optic neuritis in multiple sclerosis, or idiopathic optic neuritis.

Myelitis usually causes motor, sensory, or autonomic symptoms in the part of the body below the level of injury. Patients may have back pain, paralysis of both legs or quadriplegia, accompanied by numbness, loss of sensation or pain in the extremities, urinary retention, and defecation. Nausea, vomiting, or hiccups, which can persist, are sometimes the first symptoms of illness. “Therefore, for the treatment to be effective, early detection is very important. It is also important that this disease can recur in some patients, so preventive treatment is very necessary” – MSc.BS Ha emphasized.

Up to now, after a period of treatment at the Department of Allergy, Immunology and Dermatology and the Department of Rehabilitation at Hospital E, from paralysis of 2 lower limbs, blurred vision due to complications of the monstrous disease of neuromyelitis optica. cause, the patient was able to walk, see eyes and take care of himself. According to TS.BS Nguyen Cong Huu – Director of E Hospital, the successful diagnosis and treatment of this case requires the coordination of many specialties: neurology, active resuscitation and anti-toxicity, allergy and immunity. and dermatology, rehabilitation… These are the strong specialties of a central general hospital with a skillful combination between a team of highly qualified, well-trained and specialized doctors and nurses. , experienced. The system of modern medical equipment helps to detect many difficult and dangerous diseases in a short time, supporting the diagnosis and treatment of doctors most effectively.

According to Bich Ngoc