Herpes myelitis

Clinical history
60-year-old female with previous history of bilateral breast cancer. Recently, she developed right thoracic herpes zoster with sensory impairment of the right hemithorax. Moreover mild paresis of the right lower limb developed.

MRI findings
Image 1: Sagittal T1WI. At the TH3-TH4, discrete enlargement of the spinal cord is seen without definite abnormal signal behavior.
Image 2: Sagittal T2WI. On the contrary, on T2WI an hyperintense lesion is clearly demonstrated at the level of TH3-TH4.
Image 3: Axial T2WI. They confirm an hyperintense round lesion in the right lateral position within the spinal cord (arrow).
Image 4: Axial Gd T1WI. After Gadolinium injection, there is mild but definite enhancement (arrow) within the lesion.

Clinical evolution
Clinical symptomatology persisted for about 3 weeks and progressively, slowly resolved with time. Follow-up MRI documented disappearance of the TH3-TH4 lesion.

Final diagnosis
Herpes myelitis with complete recovery.

Search also:
- Transverse myelitis

The ESNR CD-Rom Series