Transverse myelitis

Background

  • Inflammatory disorder that involves a complete transverse section of the spinal cord
    • 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
  • Usually thoracic origin, rarely cervical spine

Clinical Features

Differential Diagnosis

Weakness

Lower Back Pain

Evaluation

  • Neurologic findings that are consistent with epidural compression but normal MRI
  • Must rule-out compressive lesion of the cord
  • MRI
    • May show cord swelling
    • Hyperintense lesion on T2 weighted images
  • LP
    • Contains monocytes, protein content is slightly increased, and IgG index is elevated[1]

Management

References

  • Perron AD, Huff JS. “Spinal Cord Disorders,” in Rosen’s Emergency Medicine Concepts and Clinical Practice, edited by Marx JA, Hockberger RS, Walls RM, et al., 1389-1395. Philadelphia: Mosby, 2010.