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August 1982

Metrizamide Myelography Combined With Computed Tomography in Adrenomyeloneuropathy

Arch Neurol. 1982;39(8):530. doi:10.1001/archneur.1982.00510200072018

To the Editor.—  Metrizamide myelography combined with computed tomographic (CT) exploration of the spine can demonstrate the presence of a thin, possibly atrophic, spinal cord and rule out compression as the cause of spastic paraparesis noted in adrenomyeloneuropathy (AMN). We describe a man with AMN who was a member of an afflicted family to stress the diagnostic support provided by this combined radiologic procedure.

Report of a Case.—  A 21-year-old man complained of increasing paraparesis and sphincter disturbances. A pyramidal syndrome involved all four limbs with Babinski's signs. There was impaired proprioception in both legs and decreased exteroceptive sensations below thoracic level 10 on the right side and lumbar L-2 on the left side. Mental functions were normal. Premature incomplete baldness and a very thin beard were noted. There were no clinical signs of adrenal insufficiency. A brother and a first cousin of the patient suffered from adrenoleukodystrophy, while his