transverse myelitis
| A heterogeneous focal inflammatory disorder of the spinal cord | |
|---|---|
| Etiology | May present singly or: - Demyelinating disorders: Multiple sclerosis, neuromyelitis optica, ADEM - systemic inflammatory disorders: sarcoidosis, SLE... |
| Epidemiology | |
| Clinical presentation | Subacute bilateral symptoms Motor: UMN AND LMN, flaccid then spastic Autonomic dysfunction: bowel and bladder dysfunction, temperature dysregulation, or labile blood pressure Differentials: Guillain-Barre syndrome, Vitamin B12 deficiency, nitrous oxide toxicity |
| Pathogenesis | |
| Diagnostic investigations | Essential to rule out surgically amenable lesions - MRI spine Paraneoplastic → auto-antibodies: anti-Hu, CRMP5, anti-amphiphysin |
| Management | Supportive The usual "critically unwell autoimmune patient" stuff like IV methylpred, IVIG, or rituximab/cyclophosphamide - depending on the likely underlying cause |