Magnetic Resonance Imaging-negative Encephalomyeloradiculopathy Diagnosed by Anti-lactosylceramide Antibody Positivity and Electrophysiological Findings: A Case Report and Review of the Literature

A 71-year-old woman developed progressive limb weakness and sensory disturbances below the thoracic level. Although myelopathy was initially considered, spinal magnetic resonance imaging (MRI) showed no abnormalities. Conversely, electrophysiological studies have identified both spinal dysfunction and radiculopathy, suggesting myeloradiculopathy. Initiation of steroid therapy resulted in immediate improvement of clinical symptoms and electrophysiological findings. Finally, anti-lactosylceramide (LacCer) antibodies were detected in the serum and cerebrospinal fluid, and titer changes correlated well with clinical improvement. This case suggests that electrophysiological studies and anti-LacCer antibodies are helpful in diagnosing and evaluating the therapeutic effects in cases of MRI-negative encephalomyeloradiculopathy.