Slow ascending myelopathy, tetraplegia, carcinoma of the bladder and amyloidosis in a patient with ankylosing spondylitis

Objective: We report a case of slow ascending myelopathy in a patient with ankylosing spondylitis (AS). Design: Case report of a 60-year-old patient suffering from AS, who develop ed over a period of 39 years a slow ascending myelopathy leading to tetrapl egia, squamous cell carcinoma of the bladder and amyloidosis of the small i ntestine secondary to neuropathic bladder and bowel. Setting: Department and Outpatient's Department of Neurological Rehabilitat ion Sheba Medical Center, Tel Hashomer, Israel. Subject: Single patient case report. Main outcome measure: Clinical follow-up of the patient between the years 1 959-1998. Results: Physical examination disclosed deteriorating incomplete tetraplegi a with hypotonia and hyporreflexia. Neurogenic bladder and bowel complicate d to squamous cell carcinoma and amyloidosis. Conclusion: To our knowledge, flaccid tetraplegia associated with AS, has n ever been reported in the literature, The possibility of vascular compressi on by the ankylosed spine causing the clinical picture of flaccid tetrapleg ia in this patient is discussed.