Diagnosis and Management of Acute Myelopathies

@article{Kaplin2005DiagnosisAM,
  title={Diagnosis and Management of Acute Myelopathies},
  author={Adam I. Kaplin and Chitra Krishnan and Deepa M. Deshpande and Carlos A. Pardo and Douglas A. Kerr},
  journal={The Neurologist},
  year={2005},
  volume={11},
  pages={2-18}
}
Background:Acute myelopathies represent a heterogeneous group of disorders with distinct etiologies, clinical and radiologic features, and prognoses. Transverse myelitis (TM) is a prototype member of this group in which an immune-mediated process causes neural injury to the spinal cord, resulting in varying degrees of weakness, sensory alterations, and autonomic dysfunction. TM may exist as part of a multifocal CNS disease (eg, MS), multisystemic disease (eg, systemic lupus erythematosus), or… 
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136 Citations
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136 Citations

Transverse Myelitis: pathogenesis, diagnosis and treatment.

Recent classification and diagnostic schemes are summarized, which provide a framework for the acute management of patients with TM and current concepts on the natural history, immunopathogenesis and treatment strategies for patients withTM are reviewed.

An approach to the diagnosis of acute transverse myelitis.

Clinical, immunological, and radiological findings of non-compressive myelopathies are reviewed, as are how these findings can be used to distinguish between demyelinating, infectious, other inflammatory, vascular, neoplastic, and paraneoplastic etiologies.

Acute Transverse Myelitis in Children, Literature Review

Acute transverse myelitis is a heterogeneous disorder in children with a broad spectrum of clinical presentation, etiology, and outcome and must be distinguished from compressive and noninflamatory myelopathies.

The Differential Diagnosis and Initial Management of Pediatric Transverse Myelitis

A guide to the basic differential considerations, diagnostic testing, and initial treatment of transverse myelitis, as well as complications to watch for and a discussion of recent data on outcomes of transVERSE Myelitis in children are provided.

Pearls: myelopathy.

Evaluation of myelopathies when no abnormalities are seen on spinal cord imaging is a commonly encountered diagnostic challenge and some "clinical pearls" in the evaluation and management of spinal cord diseases are presented.

AUTOIMMUNE TRANSVERSE MYELITIS

The investigation of transverse myelitis results in a broader appreciation of the mechanisms that lead to autoimmune neurological diseases in general, and may now be possible to initiate effective treatments in many of these disorders.

Distinct subtypes of myelitis in systemic lupus erythematosus.

It is indicated that SLE myelitis encapsulates 2 distinct and previously unrecognized syndromes that can be distinguished clinically by gray matter versus white matter findings.

Demyelinating disorders: Update on transverse myelitis

Clinical trials testing the efficacy of promising axonoprotective agents in combination with intravenous steroids in the treatment of TM are currently underway, as the levels of interleukin-6 in the cerebrospinal fluid of acute TM patients strongly correlate with and are highly predictive of disability.

Initial presentation of acute transverse myelitis in systemic lupus erythematosus: demographics, diagnosis, management and comparison to idiopathic cases

The diagnosis, demographics and management of systemic lupus erythematosus (SLE) related versus idiopathic acute transverse myelitis during the initial presentation of the disease underlines the importance of early diagnosis of patients who develop ATM related to SLE.

Post-infectious Acute Transverse Myelitis

Prognosis for children with post-infectious acute TM is quite variable, while the majority of children do have full or good recovery, many are left with residual neurologic deficits including persistent ambulatory difficulties, sensory disturbances, and/or abnormal bladder function.
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References

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