A 52-Year-Old Man With Progressive Weakness and Incontinence

Ayse Altintas; Ayca Ersen Danyeli; Subutay Berke Bozkurt; Sanem Pinar Uysal; Sergin Akpek; Murat Serhat Aygun; Olga Meltem Akay; Bulent Kahyaoglu; Selcuk Peker; Umit Barbaros Ure; Burhan Ferhanoglu

doi:10.1177/19418744211039586

A 52-Year-Old Man With Progressive Weakness and Incontinence

Neurohospitalist. 2022 Apr;12(2):307-311. doi: 10.1177/19418744211039586. Epub 2021 Aug 13.

Authors

Affiliations

¹ Department of Neurology and Koc University Research Center for Translational Medicine (KUTTAM), Koc University School of Medicine, Istanbul, Turkey.
² Acibadem University School of Medicine, Istanbul, Turkey.
³ Faculty of Medicine, University of Szeged, Szeged, Hungary.
⁴ Department of Neurology, Cleveland Clinic Foundation, Cleveland, OH, USA.
⁵ Department of Radiology, American Hospital, Istanbul, Turkey.
⁶ Department of Radiology, Koc University School of Medicine, Istanbul, Turkey.
⁷ Department of Hematology/Oncology, Koc University School of Medicine, Istanbul, Turkey.
⁸ Department of Neurology, American Hospital, Istanbul, Turkey.
⁹ Department of Neurosurgery, American Hospital, Istanbul, Turkey.

Abstract

Here we report a challenging case of a 52-year-old man presenting with subacute constipation, urinary retention, impotence, absent Achilles reflexes, and hypoesthesia in S2-S5 dermatomes. We review the clinical decision-making as the symptoms evolved and diagnostic testing changed over time. Once the diagnosis is settled, we discuss the sign and symptoms, additional diagnostic tools, treatment options and prognosis.

Keywords: central nervous system infections; cerebrovascular disorders; clinical specialty; general neurology; medical oncology; myelitis; neurooncology; stroke.