Case Presentation:
A 70-year-old right-hand dominant Asian female presented with progressive bilateral lower extremity weakness, tingling sensation, and numbness over ten months of duration. At the time of the presentation, she was unable to walk on her own and was wheelchair-bound. She further complained of urinary incontinence and constipation. There was no associated fever, dizziness, blurring of vision, auditory abnormalities, speech abnormalities, weakness in the upper limbs, and history of trauma. She has a history of hemorrhoids and mild aortic regurgitation. She is currently not under any medication and doesn’t have an account of surgical intervention in the past. She doesn’t have a significant history of known allergies or similar illnesses in her family members.
On physical examination, her vitals were within the normal limits. A neurological examination revealed decreased muscle strength on her bilateral lower limbs with a power of 3/5 bilaterally. Deep tendon reflexes were hypoactive in her lower limbs and normal in the upper limbs. There was decreased touch and pain sensation in the bilateral lower limbs. Her PCR for SARS CoV 2 was negative, and her blood reports were normal.
An MRI of the thoracolumbar spine (plain and contrast-enhanced) was done. The MRI revealed an ill-defined heterogeneously enhancing lesion in conus medullaris with dural enhancement likely to be myxopapillary ependymoma.