Specific MRI findings help distinguish acute transverse myelitis of Neuromyelitis Optica from spinal cord infarction

Kister, Ilya; Johnson, Evan; Raz, Eytan; Babb, James S.; Loh, John P.; Shepherd, Timothy M.

doi:10.1016/j.msard.2016.04.005

Cited by 46 publications

(38 citation statements)

References 18 publications

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“…The MRI features of spinal cord infarction and AQP4-Ab positive NMOSD can overlap,18 with no significant differences in lesion length, cross-sectional area and cord expansion. However, 62% of AQP4-Ab positive NMOSD cases have lesions located within 7 cm of the foramen magnum, compared with no cases of spinal cord infarction.…”

Section: Hyperacute Onsetmentioning

confidence: 97%

“…However, 62% of AQP4-Ab positive NMOSD cases have lesions located within 7 cm of the foramen magnum, compared with no cases of spinal cord infarction. Extension to the pial surface, ‘bright spotty lesions’ on axial T2 and gadolinium enhancement are also significantly more common in the AQP4-Ab positive NMOSD group but can occur in up to 30% of cases of spinal cord infarction 18. Additionally, the cerebrospinal fluid (CSF) in people with spinal cord infarction is typically normal 19.…”

Section: Hyperacute Onsetmentioning

confidence: 99%

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A practical approach to the diagnosis of spinal cord lesions

et al. 2018

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Every neurologist will be familiar with the patient with atypical spinal cord disease and the challenges of taking the diagnosis forward. This is predominantly because of the limited range of possible clinical and investigation findings making most individual features non-specific. The difficulty in obtaining a tissue diagnosis further contributes and patients are often treated empirically based on local prevalence and potential for reversibility. This article focuses on improving the diagnosis of adult non-traumatic, non-compressive spinal cord disorders. It is structured to start with the clinical presentation in order to be of practical use to the clinician. We aim, by combining the onset phenotype with the subsequent course, along with imaging and laboratory features, to improve the diagnostic process.

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Section: Hyperacute Onsetmentioning

confidence: 97%

Section: Hyperacute Onsetmentioning

confidence: 99%

A practical approach to the diagnosis of spinal cord lesions

et al. 2018

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“…While neuromyelitis optica spectrum disorder (NMOSD) is among the most frequent causes worldwide, a number of other disorders can manifest as or develop LETM over time and have risk of recurrence (1). Thus, a timely diagnosis is driven by the efforts to provide early and appropriate treatment, set measures to prevent future attacks, and avoid severe disability (2).…”

Section: Introductionmentioning

confidence: 99%

Herpes Simplex Virus Type 2 Myelitis: Case Report and Review of the Literature

et al. 2017

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Non-traumatic myelopathies can result from a wide spectrum of conditions including inflammatory, ischemic, and metabolic disorders. Here, we describe the case of a 60-year old immunocompetent woman who developed acute back pain followed by rapidly ascending flaccid tetraparesis, a C6 sensory level, and sphincter dysfunction within 8 h. Acyclovir and steroids were started on day 2 and herpes simplex virus type 2 (HSV-2) was confirmed by polymerase chain reaction in cerebrospinal fluid. Magnetic resonance imaging revealed a bilateral anterior horn tractopathy expanding from C2 to T2 and cervicothoracic cord swelling. Screening for paraneoplastic antibodies and cancer was negative. Neurophysiology aided in the work-up by corroborating root involvement. Recovery was poor despite early initiation of antiviral treatment, adjuvant anti-inflammatory therapy, and neurorehabilitation efforts. The clinical course, bilateral affection of the anterior horns, and early focal atrophy on follow-up magnetic resonance imaging take a necrotizing myelitis potentially caused by intraneuronal spread of the virus into consideration. Further, we summarize the literature on classical and rare presentations of HSV-2 myeloradiculitis in non-immunocompromised patients and raise awareness for the limited treatment options for a condition with frequent devastating outcome.

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“…1: >three vertebral segments (or short lesions -see note 2 at section 8) [9]; 2: cord swelling [9] and a gadolinium enhancement (cloud-like lesions a [28]) varying between 31, 2% [29] to 85% in acute lesions [30]; 3: T1 hypointensivity [8].…”

Section: Findings/diseasementioning

confidence: 99%

Review of the Etiological Causes and Diagnosis of Myelitis and Its Medical Orientation Protocol

Besteiro¹,

Guimarães²

2017

J Neurol Neurophysiol

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Transverse myelitis (TM) is an inflammatory condition caused by a range of possibilities which can lead to a deregulation of our motor, sensory and autonomic systems. Therefore, it creates a major impact on personal and professional life. Because it causes great social and professional disability, it is crucial that the clinicians quickly recognize this condition so that treatment can be started thereby minimizing these negative effects. Thus, the aim of this review is to provide a practical clinical approach to the most important causal diseases of TM, clinical presentation and to elaborate a diagnostic algorithm that helps classifying and simplifying the work of the clinicians when facing a TM episode.

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Specific MRI findings help distinguish acute transverse myelitis of Neuromyelitis Optica from spinal cord infarction

Cited by 46 publications

References 18 publications

A practical approach to the diagnosis of spinal cord lesions

A practical approach to the diagnosis of spinal cord lesions

Herpes Simplex Virus Type 2 Myelitis: Case Report and Review of the Literature

Review of the Etiological Causes and Diagnosis of Myelitis and Its Medical Orientation Protocol

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