Case Report/Case SeriesSaturday Night Myelopathy Flexion Myelopathy Related to Drug IntoxicationMartin, Andrew J. MBBS; Garcia, Maria C. MBBS Author Information Neurology Department, Blacktown Hospital, Blacktown, NSW, Australia A.J.M. and M.C.G.: study design, collection of data, writing first draft and final version of the manuscript. The authors declare no conflict of interest. Correspondence to: Andrew J. Martin, MBBS, Neurology Department, Blacktown Hospital, 18 Blacktown Road, Blacktown, NSW 2148, Australia. E-mail: [email protected]. The Neurologist: January 2022 - Volume 27 - Issue 1 - p 27-29 doi: 10.1097/NRL.0000000000000349 Buy Metrics Abstract Introduction: Myelopathy is a common condition with a variety of causes, often eluding diagnosis for some time. Prolonged flexion after surgical procedures has been described. Case Report: A 20-year-old female presented with acute paraparesis after polysubstance drug intoxication and a period of prolonged neck flexion while unconscious. Imaging demonstrated extensive cervicothoracic central cord signal change, in addition to posterior neck musculature hyperintensity. Additional workup directed to other causes was negative. The patient was diagnosed with flexion myelopathy and was treated with a course of steroids, with marked improvement. Conclusions: The clinician should consider the possibility of flexion-related myelopathy particularly in cases of drug intoxication or prolonged unconsciousness. Signal change within cervical musculature may provide additional clues and allow diagnosis in a timely manner. Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.