Vascular steal mimicking compression myelopathy in Paget's disease of bone: rapid reversal with calcitonin and systemic steroids

Abstract

Neurologic manifestations of Paget's disease of bone are primarily a result of mechanical compression on cranial nerves, spinal cord and roots. Less recognized is a myelopathy from "vascular steal" to highly vascularized and hypermetabolic pagetic bone. We describe a case of presumed ischemic myelitis in a patient with Paget's disease and aortic stenosis that was rapidly reversed with subcutaneous calcitonin and intravenous dexamethasone.