Transverse myelitis

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By Anthony T Reder MD

Transverse myelitis is also known as or subsumes Acute spontaneous myelitis and Myelomalacia. -ed.

Transverse myelitis is part of a spectrum of demyelinating disease but has unique features that differentiate it from multiple sclerosis. In this recently updated clinical summary, Dr. Anthony T Reder, Professor of Neurology at the University of Chicago, describes new developments in the diagnosis of subgroups of myelitis caused by neuromyelitis optica and cord involvement from CNS Sjögren disease.

Key points

  • Acute transverse myelitis, as defined here, is idiopathic and excludes other forms of myelitis (neuromyelitis optica, postinfectious and postvaccinal myelitis, multiple sclerosis, etc.)
  • Cord symptoms evolve over hours to days and then typically resolve over several weeks or months.
  • The pathology is similar to multiple sclerosis, but only 40% will develop multiple sclerosis.
  • Cord lesions in neuromyelitis optica (NMO, Devic disease) and CNS Sjögren disease are longitudinal, down the center of the cord; in multiple sclerosis the lesions are shorter and acentric.
  • High-dose glucocorticosteroids hasten recovery but have no long-term benefit.

In This Article

Historical note and nomenclature
Clinical manifestations
Clinical vignette
Pathogenesis and pathophysiology
Differential diagnosis
Diagnostic workup
Prognosis and complications
References cited