Transverse myelitis - Revision history

Rossdonaldson1 at 11:17, 14 May 2022

2022-05-14T11:17:30Z

← Older revision		Revision as of 11:17, 14 May 2022
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	*Consider work up for clotting disorder for spinal artery thrombosis, drug user, risk for [[aortic dissection]]		*Consider work up for clotting disorder for spinal artery thrombosis, drug user, risk for [[aortic dissection]]
	*Neurological consultation		*Neurological consultation
	*~~Admit for~~ [[~~corticosteroids~~]] and [[plasma exchange]]		*[[Corticosteroids]] and [[plasma exchange]]
	**High dose steroid regimen, such as [[methylprednisolone]] 1 gram daily or [[dexamethasone]] 200 mg daily		**High dose steroid regimen, such as [[methylprednisolone]] 1 gram daily or [[dexamethasone]] 200 mg daily
	*The more rapid the progression is, the worse the prognosis		*The more rapid the progression is, the worse the prognosis

			==Disposition==
			*Admission

			==See Also==
			*[[Weakness]]
			*[[Acute flaccid myelitis]]

			==External Links==

	==References==		==References==

Cdichang: /* Clinical Features */

2019-10-03T19:02:58Z

Clinical Features

← Older revision		Revision as of 19:02, 3 October 2019
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	==Clinical Features==		==Clinical Features==
	*~~May~~ progress over days-weeks		*Rapidly progressive paraplegia (as little as 4 hours), but may progress over days-weeks
	*Neck or [[back pain]] + neuro complaints:		*Neck or [[back pain]] + neuro complaints:
	**Bilateral [[weakness\|motor]], [[numbness\|sensory]], and autonomic disturbances		**Bilateral [[weakness\|motor]], [[numbness\|sensory]] (burning or tingling pain), and autonomic disturbances
	**Fecal/[[urinary retention]] and [[urinary incontinence\|incontinence]]		**Fecal/[[urinary retention]] and [[urinary incontinence\|incontinence]]

ClaireLewis at 16:44, 3 October 2019

2019-10-03T16:44:01Z

← Older revision		Revision as of 16:44, 3 October 2019
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	*May progress over days-weeks		*May progress over days-weeks
	*Neck or [[back pain]] + neuro complaints:		*Neck or [[back pain]] + neuro complaints:
	**Bilateral motor, sensory, and autonomic disturbances		**Bilateral [[weakness\|motor]], [[numbness\|sensory]], and autonomic disturbances
	**Fecal/[[urinary retention]] and incontinence		**Fecal/[[urinary retention]] and [[urinary incontinence\|incontinence]]

	==Differential Diagnosis==		==Differential Diagnosis==
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	==Evaluation==		==Evaluation==
	*Neurologic findings that are consistent with epidural compression but normal MRI		*Neurologic findings that are consistent with epidural compression but normal [[mri\|MRI]]

	~~==Management==~~
	*Must rule-out compressive lesion of the cord		*Must rule-out compressive lesion of the cord
	*[[MRI]]		*[[MRI]]
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	*[[LP]]		*[[LP]]
	**Contains monocytes, protein content is slightly increased, and IgG index is elevated<ref>http://www.merckmanuals.com/professional/neurologic_disorders/spinal_cord_disorders/acute_transverse_myelitis.html</ref>		**Contains monocytes, protein content is slightly increased, and IgG index is elevated<ref>http://www.merckmanuals.com/professional/neurologic_disorders/spinal_cord_disorders/acute_transverse_myelitis.html</ref>

			==Management==
	*Foley for bladder decompression		*Foley for bladder decompression
	*Consider work up for clotting disorder for spinal artery thrombosis, drug user, risk for [[aortic dissection]]		*Consider work up for clotting disorder for spinal artery thrombosis, drug user, risk for [[aortic dissection]]

Kxl328: /* Management */

2018-10-10T20:43:35Z

Management

← Older revision		Revision as of 20:43, 10 October 2018
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	*[[MRI]]		*[[MRI]]
	**May show cord swelling		**May show cord swelling
			**Hyperintense lesion on T2 weighted images
	*[[LP]]		*[[LP]]
	**Contains monocytes, protein content is slightly increased, and IgG index is elevated<ref>http://www.merckmanuals.com/professional/neurologic_disorders/spinal_cord_disorders/acute_transverse_myelitis.html</ref>		**Contains monocytes, protein content is slightly increased, and IgG index is elevated<ref>http://www.merckmanuals.com/professional/neurologic_disorders/spinal_cord_disorders/acute_transverse_myelitis.html</ref>

Kramarsh: /* Management */

2018-03-22T17:33:35Z

Management

← Older revision		Revision as of 17:33, 22 March 2018
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	*Foley for bladder decompression		*Foley for bladder decompression
	*Consider work up for clotting disorder for spinal artery thrombosis, drug user, risk for [[aortic dissection]]		*Consider work up for clotting disorder for spinal artery thrombosis, drug user, risk for [[aortic dissection]]
			*Neurological consultation
	*Admit for [[corticosteroids]] and [[plasma exchange]]		*Admit for [[corticosteroids]] and [[plasma exchange]]
			**High dose steroid regimen, such as [[methylprednisolone]] 1 gram daily or [[dexamethasone]] 200 mg daily
	*The more rapid the progression is, the worse the prognosis		*The more rapid the progression is, the worse the prognosis

Jesse: /* Background */

2017-08-28T21:36:28Z

Background

← Older revision		Revision as of 21:36, 28 August 2017
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	==Background==		==Background==
	*Inflammatory disorder that involves a complete transverse section of the spinal cord		*Inflammatory disorder that involves a complete transverse section of the spinal cord
	**Results from viral infection, postvaccination or as part of [[MS]], [[SLE]], or cancer		**Results from viral infection (30% of cases), postvaccination or as part of [[MS]], [[SLE]], or cancer
	*May present exactly like a compressive lesion of the spinal cord		*May present exactly like a compressive lesion of the spinal cord
	*Usually thoracic origin, rarely cervical spine		*Usually thoracic origin, rarely cervical spine

ClaireLewis: /* Management */

2017-04-03T17:53:16Z

Management

← Older revision		Revision as of 17:53, 3 April 2017
Line 27:		Line 27:
	*Foley for bladder decompression		*Foley for bladder decompression
	*Consider work up for clotting disorder for spinal artery thrombosis, drug user, risk for [[aortic dissection]]		*Consider work up for clotting disorder for spinal artery thrombosis, drug user, risk for [[aortic dissection]]
	*Admit for [[corticosteroids]] and plasma exchange		*Admit for [[corticosteroids]] and [[plasma exchange]]
	*The more rapid the progression is, the worse the prognosis		*The more rapid the progression is, the worse the prognosis

Neil.m.young: Text replacement - "==Diagnosis==" to "==Evaluation=="

2016-07-27T03:41:01Z

Text replacement - "==Diagnosis==" to "==Evaluation=="

← Older revision		Revision as of 03:41, 27 July 2016
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	{{Lower back pain DDX}}		{{Lower back pain DDX}}

	==~~Diagnosis~~==		==Evaluation==
	*Neurologic findings that are consistent with epidural compression but normal MRI		*Neurologic findings that are consistent with epidural compression but normal MRI

ClaireLewis: /* Diagnosis */

2016-07-13T23:34:58Z

Diagnosis

← Older revision		Revision as of 23:34, 13 July 2016
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	==Diagnosis==		==Diagnosis==
	*Neurologic findings that are ~~c/w~~ epidural compression but normal MRI		*Neurologic findings that are consistent with epidural compression but normal MRI

	==Management==		==Management==

ClaireLewis: /* Clinical Features */

2016-07-13T23:34:32Z

Clinical Features

← Older revision		Revision as of 23:34, 13 July 2016
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	==Clinical Features==		==Clinical Features==
	*May progress over days-weeks		*May progress over days-weeks
	*Neck or back pain + neuro complaints:		*Neck or [[back pain]] + neuro complaints:
	**Bilateral motor, sensory, and autonomic disturbances		**Bilateral motor, sensory, and autonomic disturbances
	**Fecal/urinary retention and incontinence		**Fecal/[[urinary retention]] and incontinence

	==Differential Diagnosis==		==Differential Diagnosis==