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A 36-year-old Chinese woman, previously well, presented with lower back pain followed by subacute onset of bilateral leg weakness, numbness and urinary retention progressing over five days. There were no infective or constitutional symptoms, preceding trauma nor use of anticoagulation. On examination, she had bilateral upper motor neurone pattern lower limb weakness (MRC grade 3) with a T12 sensory level, lax anal tone and urinary retention requiring catheterisation. Her cranial nerves, vision and upper limbs were normal.