Disclosures: Michael Arias, MPH: No financial relationships or conflicts of interest

Case Description: A 69-year-old female with past medical history significant for hypertension and hyperlipidemia presented to the emergency department with acute onset of right upper and lower extremity paralysis. Evaluation consisted of CT of the head, MRI of the brain, CBC, CMP, coagulation studies, and inflammatory markers, CSF analysis, and MRI of the cervical spine. T2-weighted MRI of the cervical spine revealed hyperintensity on the right side of the spinal cord, C3-C5. Patient was diagnosed with unilateral myelitis and treated with IV steroid for 5 days. Once medically stabilized, she was transferred to acute inpatient rehabilitation for a physiatry-led comprehensive rehabilitation program. Functionally, patient was at a total-to-max assist for ambulation and ADLs. Patient underwent intense physiatry-led rehabilitation program with physical therapy and occupational therapy, and was discharged at independent level for all ADLs and modified independent for ambulation.

Setting: Acute inpatient physiatry hospital

Patient: 69-year-old Caucasian female Assessment/

Results: T2 weighted MRI of the spine: Hyperintensity, right spinal cord C3-C5. Brain MRI: No acute intracranial events. CSF analysis: Increased proteins, No oligoclonal bands, Negative NMO-IgG and MOG-IgG antibodies

Discussion: Unilateral myelitis is a rare neurological disease that causes impaired mobility and ADL dysfunction. These patients could benefit from acute inpatient rehabilitation given their weakness and potential for complications. It is beneficial for these patients to have close monitoring by a physiatry-led rehabilitation team to monitor response to treatment or need for retreatment, and prevent complications.

Conclusion: This is a case of unilateral myelitis, a rare condition that presents a unique challenge to physiatrist. The physiatry-led comprehensive rehabilitation program implemented for this patient allowed her to be discharged home at a modified independent level for ambulation and independent levels for ADLs. These patients would benefit from close monitoring to work on gait, mobility, ADLs, transfers, patient safety, and patient/family education.

Level of Evidence: Level V

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/physiatry-led-rehabilitation-in-a-69-year-old-female-with-unilateral-myelitis-a-case-report/