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Acute Transverse Myelopathy
Jeffrey S. Ross, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        TERMINOLOGY

        • Abbreviations

          • Acute transverse myelitis (ATM)
          • Multiple sclerosis (MS)
          • Neuromyelitis optica (NMO)
        • Synonyms

          • Acute noncompressive myelopathies
        • Definitions

          • Acute transverse myelopathy is a broad generic term encompassing heterogeneous group of disorders causing cord dysfunction
            • Etiologies include inflammatory causes (ATM) + vascular disease  + radiation + paraneoplastic + idiopathic (unknown)
            • ATM more specific term for cord dysfunction that is inflammatory in etiology
              • Inflammation defined by CSF findings and MR enhancement

        IMAGING

        • General Features

          • CT Findings

            • MR Findings

              • Nonvascular Interventions

                • Imaging Recommendations

                  DIFFERENTIAL DIAGNOSIS

                    PATHOLOGY

                    • General Features

                      • Microscopic Features

                        CLINICAL ISSUES

                        • Presentation

                          • Demographics

                            • Natural History & Prognosis

                              • Treatment

                                DIAGNOSTIC CHECKLIST

                                • Consider

                                  Selected References

                                  1. Beh SC et al: Transverse myelitis. Neurol Clin. 31(1):79-138, 2013
                                  2. Sheerin F et al: Magnetic resonance imaging of acute intramedullary myelopathy: radiological differential diagnosis for the on-call radiologist. Clin Radiol. 64(1):84-94, 2009
                                  3. Jacob A et al: An approach to the diagnosis of acute transverse myelitis. Semin Neurol. 28(1):105-20, 2008
                                  4. Ross JS: ATM--OMG! AJNR Am J Neuroradiol. 29(4):618, 2008
                                  5. Pittock SJ et al: Inflammatory transverse myelitis: evolving concepts. Curr Opin Neurol. 19(4):362-8, 2006
                                  6. Harzheim M et al: Discriminatory features of acute transverse myelitis: a retrospective analysis of 45 patients. J Neurol Sci. 217(2):217-23, 2004
                                  7. Berger JR et al: Infectious myelopathies. Semin Neurol. 22(2): 133-42, 2002
                                  8. Sherer Y et al: Transverse myelitis in patients with antiphospholipid antibodies--the importance of early diagnosis and treatment. Clin Rheumatol. 21(3):207-10, 2002
                                  9. Transverse Myelitis Consortium Working Group: Proposed diagnostic criteria and nosology of acute transverse myelitis. Neurology. 59(4):499-505, 2002
                                  10. Goebels N et al: Extensive myelitis associated with Mycoplasma pneumoniae infection: magnetic resonance imaging and clinical long-term follow-up. J Neurol. 248(3):204-8, 2001
                                  11. Scotti G et al: Diagnosis and differential diagnosis of acute transverse myelopathy. The role of neuroradiological investigations and review of the literature. Neurol Sci. 22 Suppl 2:S69-73, 2001
                                  12. Kovacs B et al: Transverse myelopathy in systemic lupus erythematosus: an analysis of 14 cases and review of the literature. Ann Rheum Dis. 59(2):120-4, 2000
                                  13. Tartaglino LM et al: MR imaging in a case of postvaccination myelitis. AJNR Am J Neuroradiol. 16(3):581-2, 1995
                                  14. Austin SG et al: The role of magnetic resonance imaging in acute transverse myelitis. Can J Neurol Sci. 19(4):508-11, 1992
                                  Related Anatomy
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                                  Related Differential Diagnoses
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                                  References
                                  Tables

                                  Tables

                                  KEY FACTS

                                  • Terminology

                                    • Imaging

                                      • Top Differential Diagnoses

                                        TERMINOLOGY

                                        • Abbreviations

                                          • Acute transverse myelitis (ATM)
                                          • Multiple sclerosis (MS)
                                          • Neuromyelitis optica (NMO)
                                        • Synonyms

                                          • Acute noncompressive myelopathies
                                        • Definitions

                                          • Acute transverse myelopathy is a broad generic term encompassing heterogeneous group of disorders causing cord dysfunction
                                            • Etiologies include inflammatory causes (ATM) + vascular disease  + radiation + paraneoplastic + idiopathic (unknown)
                                            • ATM more specific term for cord dysfunction that is inflammatory in etiology
                                              • Inflammation defined by CSF findings and MR enhancement

                                        IMAGING

                                        • General Features

                                          • CT Findings

                                            • MR Findings

                                              • Nonvascular Interventions

                                                • Imaging Recommendations

                                                  DIFFERENTIAL DIAGNOSIS

                                                    PATHOLOGY

                                                    • General Features

                                                      • Microscopic Features

                                                        CLINICAL ISSUES

                                                        • Presentation

                                                          • Demographics

                                                            • Natural History & Prognosis

                                                              • Treatment

                                                                DIAGNOSTIC CHECKLIST

                                                                • Consider

                                                                  Selected References

                                                                  1. Beh SC et al: Transverse myelitis. Neurol Clin. 31(1):79-138, 2013
                                                                  2. Sheerin F et al: Magnetic resonance imaging of acute intramedullary myelopathy: radiological differential diagnosis for the on-call radiologist. Clin Radiol. 64(1):84-94, 2009
                                                                  3. Jacob A et al: An approach to the diagnosis of acute transverse myelitis. Semin Neurol. 28(1):105-20, 2008
                                                                  4. Ross JS: ATM--OMG! AJNR Am J Neuroradiol. 29(4):618, 2008
                                                                  5. Pittock SJ et al: Inflammatory transverse myelitis: evolving concepts. Curr Opin Neurol. 19(4):362-8, 2006
                                                                  6. Harzheim M et al: Discriminatory features of acute transverse myelitis: a retrospective analysis of 45 patients. J Neurol Sci. 217(2):217-23, 2004
                                                                  7. Berger JR et al: Infectious myelopathies. Semin Neurol. 22(2): 133-42, 2002
                                                                  8. Sherer Y et al: Transverse myelitis in patients with antiphospholipid antibodies--the importance of early diagnosis and treatment. Clin Rheumatol. 21(3):207-10, 2002
                                                                  9. Transverse Myelitis Consortium Working Group: Proposed diagnostic criteria and nosology of acute transverse myelitis. Neurology. 59(4):499-505, 2002
                                                                  10. Goebels N et al: Extensive myelitis associated with Mycoplasma pneumoniae infection: magnetic resonance imaging and clinical long-term follow-up. J Neurol. 248(3):204-8, 2001
                                                                  11. Scotti G et al: Diagnosis and differential diagnosis of acute transverse myelopathy. The role of neuroradiological investigations and review of the literature. Neurol Sci. 22 Suppl 2:S69-73, 2001
                                                                  12. Kovacs B et al: Transverse myelopathy in systemic lupus erythematosus: an analysis of 14 cases and review of the literature. Ann Rheum Dis. 59(2):120-4, 2000
                                                                  13. Tartaglino LM et al: MR imaging in a case of postvaccination myelitis. AJNR Am J Neuroradiol. 16(3):581-2, 1995
                                                                  14. Austin SG et al: The role of magnetic resonance imaging in acute transverse myelitis. Can J Neurol Sci. 19(4):508-11, 1992