Hepatic Myelopathy with Painful Tonic Spasm: A Case Report

Hepatic myelopathy (HM) is a rare neurological complication of chronic liver disease, causing progressive spastic paraplegia or quadriplegia in the extremities with minimal sensory or sphincter impairment. In this article, the authors present one additional case with HM, with an exceptional clinical picture of painful tonic spasms within both thighs as the main complaint. A reduction in pain coinciding with a reduction in spasticity from treatments such as baclofen suggests a causal relationship between the two. We stress the importance of early recognizing this symptom before the spinal cord damage becomes irreversible.