Identifying Transverse Myelitis in the Emergency Care Arena

Abstract

Transverse myelitis (TM) is a neurological syndrome involving destruction of the anterior and posterior (transverse) segments of the spinal cord. The objective of this article is to educate emergency nurses and nurse practitioners about how to recognize, diagnose, and treat TM. A comparison of the neurological findings of TM and Guillain-Barré syndrome is presented. In addition, this article will include an algorithm and specific diagnostic criteria to assist in the diagnosis of acute idiopathic TM.

Acute cervical cord infarction in anterior spinal artery territory with acute swelling mimicking myelitis

“… 6 It may affect any segment of the spinal cord. 5 Patients commonly present with subacute back pain along with motor, sensory, and autonomic deficits. 3 , 5 , 6 Laboratory tests and CSF analysis may aid in establishing diagnosis and identification of the etiologic agent.…”

“… 5 Patients commonly present with subacute back pain along with motor, sensory, and autonomic deficits. 3 , 5 , 6 Laboratory tests and CSF analysis may aid in establishing diagnosis and identification of the etiologic agent. 5 Like infarction, myelitis may present as cord swelling at the level of the lesion on MRI T2-weighted images with hyperintensity.…”

“… 3 , 5 , 6 Laboratory tests and CSF analysis may aid in establishing diagnosis and identification of the etiologic agent. 5 Like infarction, myelitis may present as cord swelling at the level of the lesion on MRI T2-weighted images with hyperintensity. 9 There is no definitive cure for acute transverse myelitis.…”

“… 3 , 4 Acute myelitis, on the other hand, may lead to damage of the functional areas at the affected segment of the cord. 5 , 6 Like infarction, patients may present with pain, weakness or paralysis, sensory, and autonomic deficits. 3 , 4 , 6 The disease may be idiopathic or attributed to other CNS, or systemic etiologies.…”

Acute Disseminated Encephalomyelitis After Influenza Vaccination: A Case Report

“…Third, does the patient experience any urinary retention or loss of bowel control? 20 (Many patients with ADEM have difficulties in elimination.) Fourth, laboratory studies should include analysis of cerebrospinal fluid and blood to evaluate oligoclonal bands and levels of aquaporin-4 antibodies, and other blood analysis as needed to test for other potential immunosuppression-related diseases such as systemic lupus erythematosus or Guillain-Barré syndrome.…”