Acute flaccid paraparesis secondary to bilateral ischaemic lumbosacral plexopathy

摘要

A 47-year-old gentleman with a history of hypertension, type 2 diabetes mellitus, hypercholesterolemia, coronary artery disease and left iliofemoral bypass woke up with discomfort, numbness and severe weakness of both legs. He was a non-smoker and had no history of alcohol or drug abuse. There was an approximate 6 month history of intermittent clau-dication affecting his lower limbs. He denied recent weight loss and had a good glycaemic control. His regular medications included aspirin, atorvastatin, amlodipine, bisoprolol, gabapentin, metformin and lisinopril. Neurological examination demonstrated asymmetric flaccid paraparesis, worse on the left. He was not able to weight bear. Lower limb reflexes were absent. There was impairment of pinprick and touch sensation below the mid-thigh bilaterally but no definite sensory level.