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Highlights & Basics
- Transverse myelitis (TM) is a heterogeneous focal inflammatory disorder of the spinal cord characterized by acute or subacute development of motor weakness, sensory impairment, and autonomic dysfunction.
- TM causes motor weakness, a sensory impairment below the lesions, and bowel and bladder dysfunction.
- Clinical characteristics and magnetic resonance imaging (MRI) of the spinal cord classify TM into acute partial or longitudinally extensive variants.
- The presence of TM is confirmed by lumbar puncture demonstrating increased white blood cell count and absence of infection, with or without spinal cord MRI revealing a cord lesion that enhances after gadolinium administration.
- For people with a characteristic brain MRI, the acute partial variant suggests a high future risk of developing multiple sclerosis (MS).
Quick Reference
History & Exam
Key Factors
Other Factors
Diagnostics Tests
Treatment Options
Definition
Epidemiology
Etiology
Pathophysiology
Images
Sagittal T2-weighted MRI of cervical spinal cord showing myelitis lesion
Axial T2-weighted MRI of cervical spinal cord showing myelitis lesion
Sagittal T2-weighted MRI showing multiple sclerosis-related myelitis lesion
Sagittal T2-weighted MRI showing longitudinally extensive TM lesion
Sagittal T1-weighted MRI showing enhancement of neuromyelitis optica-related lesion
The McDonald criteria for the diagnosis of multiple sclerosis
Proposed criteria for diagnosis of myelin oligodendrocyte glycoprotein antibody associated disease (MOGAD)
Citations
Transverse Myelitis Consortium Working Group. Proposed diagnostic criteria and nosology of acute transverse myelitis. Neurology. 2002 Aug 27;59(4):499-505.[Abstract]
Expert Panel on Neurological Imaging, Agarwal V, Shah LM, et al. ACR appropriateness criteria® myelopathy: 2021 update. J Am Coll Radiol. 2021 May;18(5s):S73-82.[Abstract][Full Text]
Rae-Grant A, Day GS, Marrie RA, et al. Practice guideline recommendations summary: disease-modifying therapies for adults with multiple sclerosis. Neurology. 2018 Apr 24;90(17):777-88.[Abstract][Full Text]
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