Paresthesias]

A 23-year-old patient suddenly experienced paresthesia in both legs which progressively ascended to the region of the umbilicus and finally also occurred in all fingers. The physical examination revealed a decreased sensation for touch, discrimination and vibration in all paresthetical regions and on the stem even up to dermatome C5. A mild elevation of the protein content, a mononuclear pleocytosis and oligoclonal bands were found in the cerebrospinal fluid. Magnetic resonance imaging of the cervical spinal cord showed a hyperintensive lesion in the region of the posterior tract at C6. With respect to these findings and after exclusion of other neurological affections, multiple sclerosis was diagnosed. The symptoms subsided spontaneously within five weeks, and the patient was discharged without any complaints. The diagnostic accuracy of the various findings is discussed.