Table 2.
Patient | Baseline | 3-month follow-up | 6-month follow-up | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Deep tendon reflexes | Sensory symptoms and signs | MRC scale Upper limbs: R/L | MRC scale Lower limbs: R/L | Deep tendon reflexes | Sensory symptoms and signs | MRC scale Upper limbs: R/L | MRC scale Lower limbs: R/L | Deep tendon reflexes | Sensory symptoms and signs | MRC scale Upper limbs: R/L | MRC scale Lower limbs: R/L | |
#1 | Absent in the lower and upper limbs, normal plantar reflex response bilaterally | Severe hypoesthesia in the lower limbs till the superior anterior iliac spine | 39/35 | 19/21 | Hyporeflexia only in the lower limbs, normal plantar reflex response bilaterally | Moderate hypoesthesia at the lower limbs | 24/24 | 9/9 | Areflexia of the Achilles reflexes; DPR normalized in the other districts; normal plantar reflex response bilaterally | Mild hypoesthesia in the lower limbs, till the ankle | 42/41 | 18/18 |
#2 | Hyporeflexia in the upper limbs, areflexia in the lower limbs, silent plantar reflex response bilaterally | Distal hypoesthesia and paresthesia in the four limbs | 21/23 | 6/8 | Hyporeflexia in the upper limbs, areflexia in the lower limbs, silent plantar reflex response bilaterally | Slight improvement of the distal hypoesthesia and paresthesia in the four limbs | 22/24 | 6/9 | Hyporeflexia in the lower limbs, abnormal plantar reflex response bilaterally | Mild distal paraesthesia in the lower limbs | 28/29 | 13/14 |
#3 | Hyporeflexia of the patellar reflexes, areflexia of the Achilles tendon reflexes, silent plantar reflex response bilaterally | Distal hypoesthesia in the four limbs more prominent in the right lower limb below the knee; distal apallesthesia in the lower limbs | 41/41 | 12/25 | Areflexia of the Achilles reflexes, silent plantar reflex response bilaterally | Mild recovery of the hypoesthesia now confined to the right lower limb above the knee and at the left foot; no variation in the distal apallesthesia in the lower limbs | 42/38 | 17/19 | NA | NA | NA | NA |
#4 | Hyporeflexia in the upper limbs, areflexia in the lower limbs, bilateral Babinski sign | Severe hypoesthesia and hypopallesthesia in the lower limbs | 40/40 | 9/6 | Hyperreflexia in the lower limbs, bilateral Babinski sign | Mild hypoesthesia in the lower limbs | 40/40 | 21/20 | Mild hyperreflexia at lower limbs, bilateral Babinski sign | Normal | 40/40 | 24/24 |
#5 | Hyperreflexia of the patellar and Achilles tendon reflexes, bilateral Babinski sign | Severe hypoesthesia and hypopallesthesia in the lower part of the body with upper level at T4-T5 | 40/40 | 16/16 | Hyperreflexia of the patellar and Achilles reflexes with ankle clonus; bilateral Babinski sign | Moderate improvement of the hypoesthesia, upper level at T4-T5 | 40/40 | 19/20 | Hyperreflexia of the patellar and Achilles reflexes with ankle clonus; bilateral Babinski sign | Mild hypoesthesia with upper level T4-T5 | 40/40 | 24/24 |
DPR, Deep Tendon Reflexes; MRC, Medical Research Council Scale for muscle strength assessment. Muscle effort evaluated in the upper limbs (sum score ranging between 0 and 40 for each body side) included: deltoid, biceps brachii, triceps brachii, wrist extension, wrist flexion, finger extension, finger flexion, first dorsal interosseous muscles. Muscle effort evaluated in the lower limbs (sum score ranging between 0 and 25 for each body side) included: iliopsoas, quadriceps femoralis, gastrocnemius, tibialis anterior, extensor hallucis longus mucles.