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A 63-year-old man presented with sudden bilateral lower limb weakness and right-sided sensory loss to pain and temperature on a background of recently diagnosed biopsy-negative giant cell arteritis (GCA) treated with prednisone 50 mg. Erythrocyte sedimentation rate was normal. Somatosensory evoked potentials revealed central conduction delay. PET/CT imaging revealed major vessel hypermetabolism (Figure 1), indicative of active GCA, confirmed on repeat temporal artery biopsy (Figure 2). Spinal cord involvement was suspected; IV steroids and cyclophosphamide followed by tocilizumab were commenced with good response. Clinicians should be aware of rare manifestations of GCA1 and PET-CT might be helpful in evaluation of disease activity.2
Footnotes
Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
Submitted and editor reviewed. The handling editor was Editor-in-Chief José Merino, MD, MPhil.
- Received November 21, 2021.
- Accepted in final form April 4, 2022.
- © 2022 American Academy of Neurology
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