Proceedings 31st Symposium ESVN-ECVN

A 7‐year‐old male DSH was presented with an acute episode of dysuria and plantigradism of two weeks duration. Neurological examination revealed plantigradism, pelvic limb muscle atrophy, ambulatory paraparesis with delayed postural reactions in both pelvic limbs, decreased withdrawal reflexes and lumbosacral pain suggesting a L6‐S3 lesion. Toxoplasma spp. IgG antibodies were 1/80 and IgM were positive suggesting exposure. Myelo‐CT showed a left extradural medullar compression at the level of L6‐L7 intervertebral space. Cerebrospinal fluid analysis from a lumbar puncture showed proteinocytologic dissociation. An exploratory left‐side hemilaminectomy revealed a left L6 spinal nerve enlargement of which biopsies were taken. The results of histopathology showed a pyogranulomatous ganglioneuritis and radicular edema and Toxoplasma spp. immunohistochemistry was negative. A diagnosis of immune‐mediated pyogranulomatous ganglioneuritis was reached. Treatment with prednisone was initiated at 1mg/kg BID and was tapered following clinical remission for eight months. Motor function and muscular atrophy recovery has been almost complete ten months after diagnosis with only slight paresthesia managed with pregabalin remaining.