Hepatic Myelopathy: Case Report of an Unusual MRI Finding

Hepatic myelopathy is a very rare complication of chronic liver disease. Patients classically present with progressive spastic paraparesis and pathologic findings of selective and symmetric loss of myelin in bilateral corticospinal tracts. Yet, imaging studies, including spine MR imaging, are usually unremarkable. We present a unique case of hepatic myelopathy that provides imaging correlation to previously described pathologic findings. A brief review of the hepatic myelopathy literature is also included.