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Inflammatory Myelopathies
Blaise V. Jones, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Synonyms

              • Acute flaccid paralysis
            • Definitions

              • Acute inflammatory pathologies of spinal cord, not secondary to other CNS inflammatory or demyelinating disease
                • Transverse myelitis (TM)
                • Acute flaccid myelitis (AFM)
                • Guillain-Barré syndrome (GBS)
                • Paralytic poliomyelitis

            IMAGING

            • General Features

              • CT Findings

                • MR Findings

                  • Imaging Recommendations

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        CLINICAL ISSUES

                        • Presentation

                          • Demographics

                            • Natural History & Prognosis

                              DIAGNOSTIC CHECKLIST

                              • Image Interpretation Pearls

                                Selected References

                                1. Caress JB et al: COVID-19-associated Guillain-Barré syndrome: the early pandemic experience. Muscle Nerve. 62(4):485-91, 2020
                                2. Chhabda S et al: Relapsing demyelinating syndromes in children: a practical review of neuroradiological mimics. Front Neurol. 11:627, 2020
                                3. Kaur H et al: Transverse myelitis in a child with COVID-19. Pediatr Neurol. 112:5-6, 2020
                                4. Bulut E et al: MRI predictors of recurrence and outcome after acute transverse myelitis of unidentified etiology. AJNR Am J Neuroradiol. 40(8):1427-32, 2019
                                5. Christy A et al: Acute flaccid myelitis associated with enterovirus D68: a review. J Child Neurol. 34(9):511-6, 2019
                                6. Grill MF: Infectious myelopathies. Continuum (Minneap Minn). 24(2, Spinal Cord Disorders):441-73, 2018
                                7. Absoud M et al: Pediatric transverse myelitis. Neurology. 87(9 Suppl 2):S46-52, 2016
                                8. Sorte DE et al: Longitudinally extensive myelopathy in children. Pediatr Radiol. 45(2):244-57; quiz 241-3, 2015
                                9. Cree BA: Acute inflammatory myelopathies. Handb Clin Neurol. 122:613-67, 2014
                                10. Maloney JA et al: MRI findings in children with acute flaccid paralysis and cranial nerve dysfunction occurring during the 2014 enterovirus D68 outbreak. AJNR Am J Neuroradiol. 36(2):245-50, 2014
                                11. Landau YE et al: Pediatric neurologic complications associated with influenza A H1N1. Pediatr Neurol. 44(1):47-51, 2011
                                12. Scott TF et al: Evidence-based guideline: clinical evaluation and treatment of transverse myelitis: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology. 77(24):2128-34, 2011
                                13. Bigi S et al: Acute transverse myelitis in Lyme neuroborreliosis. Infection. 38(5):413-6, 2010
                                14. Agmon-Levin N et al: Transverse myelitis and vaccines: a multi-analysis. Lupus. 18(13):1198-204, 2009
                                15. Csábi G et al: Transverse myelitis as a rare, serious complication of Mycoplasma pneumoniae infection. Pediatr Neurol. 41(4):312-3, 2009
                                16. Kalra V et al: Childhood acute transverse myelitis: clinical profile, outcome, and association with antiganglioside antibodies. J Child Neurol. 24(4):466-71, 2009
                                17. Pandit L: Transverse myelitis spectrum disorders. Neurol India. 57(2):126-33, 2009
                                18. Lee JW et al: Diffusion tensor imaging in idiopathic acute transverse myelitis. AJR Am J Roentgenol. 191(2):W52-7, 2008
                                19. Andronikou S et al: MRI findings in acute idiopathic transverse myelopathy in children. Pediatr Radiol. 33(9):624-9, 2003
                                20. Kerr DA et al: Immunopathogenesis of acute transverse myelitis. Curr Opin Neurol. 15(3):339-47, 2002
                                21. Transverse Myelitis Consortium Working Group: proposed diagnostic criteria and nosology of acute transverse myelitis. Neurology. 59(4):499-505, 2002
                                22. 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
                                23. Misra UK et al: Role of MRI in acute transverse myelitis. Neurol India. 47(4):253-4, 1999
                                24. Murthy JM et al: Acute transverse myelitis: MR characteristics. Neurol India. 47(4):290-3, 1999
                                25. Isoda H et al: MR imaging of acute transverse myelitis (myelopathy). Radiat Med. 16(3):179-86, 1998
                                26. Choi KH et al: Idiopathic transverse myelitis: MR characteristics. AJNR Am J Neuroradiol. 17(6):1151-60, 1996
                                27. Kornreich L et al: MRI in acute poliomyelitis. Neuroradiology. 38(4):371-2, 1996
                                28. Misra UK et al: A clinical, MRI and neurophysiological study of acute transverse myelitis. J Neurol Sci. 138(1-2):150-6, 1996
                                29. Campi A et al: Acute transverse myelopathy: spinal and cranial MR study with clinical follow-up. AJNR Am J Neuroradiol. 16(1):115-23, 1995
                                30. Jeffery DR et al: Transverse myelitis. Retrospective analysis of 33 cases, with differentiation of cases associated with multiple sclerosis and parainfectious events. Arch Neurol. 50(5):532-5, 1993
                                31. Dunne K et al: Acute transverse myelopathy in childhood. Dev Med Child Neurol. 28(2):198-204, 1986
                                Related Anatomy
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                                Related Differential Diagnoses
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                                References
                                Tables

                                Tables

                                KEY FACTS

                                • Terminology

                                  • Imaging

                                    • Top Differential Diagnoses

                                      • Pathology

                                        • Clinical Issues

                                          TERMINOLOGY

                                          • Synonyms

                                            • Acute flaccid paralysis
                                          • Definitions

                                            • Acute inflammatory pathologies of spinal cord, not secondary to other CNS inflammatory or demyelinating disease
                                              • Transverse myelitis (TM)
                                              • Acute flaccid myelitis (AFM)
                                              • Guillain-Barré syndrome (GBS)
                                              • Paralytic poliomyelitis

                                          IMAGING

                                          • General Features

                                            • CT Findings

                                              • MR Findings

                                                • Imaging Recommendations

                                                  DIFFERENTIAL DIAGNOSIS

                                                    PATHOLOGY

                                                    • General Features

                                                      CLINICAL ISSUES

                                                      • Presentation

                                                        • Demographics

                                                          • Natural History & Prognosis

                                                            DIAGNOSTIC CHECKLIST

                                                            • Image Interpretation Pearls

                                                              Selected References

                                                              1. Caress JB et al: COVID-19-associated Guillain-Barré syndrome: the early pandemic experience. Muscle Nerve. 62(4):485-91, 2020
                                                              2. Chhabda S et al: Relapsing demyelinating syndromes in children: a practical review of neuroradiological mimics. Front Neurol. 11:627, 2020
                                                              3. Kaur H et al: Transverse myelitis in a child with COVID-19. Pediatr Neurol. 112:5-6, 2020
                                                              4. Bulut E et al: MRI predictors of recurrence and outcome after acute transverse myelitis of unidentified etiology. AJNR Am J Neuroradiol. 40(8):1427-32, 2019
                                                              5. Christy A et al: Acute flaccid myelitis associated with enterovirus D68: a review. J Child Neurol. 34(9):511-6, 2019
                                                              6. Grill MF: Infectious myelopathies. Continuum (Minneap Minn). 24(2, Spinal Cord Disorders):441-73, 2018
                                                              7. Absoud M et al: Pediatric transverse myelitis. Neurology. 87(9 Suppl 2):S46-52, 2016
                                                              8. Sorte DE et al: Longitudinally extensive myelopathy in children. Pediatr Radiol. 45(2):244-57; quiz 241-3, 2015
                                                              9. Cree BA: Acute inflammatory myelopathies. Handb Clin Neurol. 122:613-67, 2014
                                                              10. Maloney JA et al: MRI findings in children with acute flaccid paralysis and cranial nerve dysfunction occurring during the 2014 enterovirus D68 outbreak. AJNR Am J Neuroradiol. 36(2):245-50, 2014
                                                              11. Landau YE et al: Pediatric neurologic complications associated with influenza A H1N1. Pediatr Neurol. 44(1):47-51, 2011
                                                              12. Scott TF et al: Evidence-based guideline: clinical evaluation and treatment of transverse myelitis: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology. 77(24):2128-34, 2011
                                                              13. Bigi S et al: Acute transverse myelitis in Lyme neuroborreliosis. Infection. 38(5):413-6, 2010
                                                              14. Agmon-Levin N et al: Transverse myelitis and vaccines: a multi-analysis. Lupus. 18(13):1198-204, 2009
                                                              15. Csábi G et al: Transverse myelitis as a rare, serious complication of Mycoplasma pneumoniae infection. Pediatr Neurol. 41(4):312-3, 2009
                                                              16. Kalra V et al: Childhood acute transverse myelitis: clinical profile, outcome, and association with antiganglioside antibodies. J Child Neurol. 24(4):466-71, 2009
                                                              17. Pandit L: Transverse myelitis spectrum disorders. Neurol India. 57(2):126-33, 2009
                                                              18. Lee JW et al: Diffusion tensor imaging in idiopathic acute transverse myelitis. AJR Am J Roentgenol. 191(2):W52-7, 2008
                                                              19. Andronikou S et al: MRI findings in acute idiopathic transverse myelopathy in children. Pediatr Radiol. 33(9):624-9, 2003
                                                              20. Kerr DA et al: Immunopathogenesis of acute transverse myelitis. Curr Opin Neurol. 15(3):339-47, 2002
                                                              21. Transverse Myelitis Consortium Working Group: proposed diagnostic criteria and nosology of acute transverse myelitis. Neurology. 59(4):499-505, 2002
                                                              22. 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
                                                              23. Misra UK et al: Role of MRI in acute transverse myelitis. Neurol India. 47(4):253-4, 1999
                                                              24. Murthy JM et al: Acute transverse myelitis: MR characteristics. Neurol India. 47(4):290-3, 1999
                                                              25. Isoda H et al: MR imaging of acute transverse myelitis (myelopathy). Radiat Med. 16(3):179-86, 1998
                                                              26. Choi KH et al: Idiopathic transverse myelitis: MR characteristics. AJNR Am J Neuroradiol. 17(6):1151-60, 1996
                                                              27. Kornreich L et al: MRI in acute poliomyelitis. Neuroradiology. 38(4):371-2, 1996
                                                              28. Misra UK et al: A clinical, MRI and neurophysiological study of acute transverse myelitis. J Neurol Sci. 138(1-2):150-6, 1996
                                                              29. Campi A et al: Acute transverse myelopathy: spinal and cranial MR study with clinical follow-up. AJNR Am J Neuroradiol. 16(1):115-23, 1995
                                                              30. Jeffery DR et al: Transverse myelitis. Retrospective analysis of 33 cases, with differentiation of cases associated with multiple sclerosis and parainfectious events. Arch Neurol. 50(5):532-5, 1993
                                                              31. Dunne K et al: Acute transverse myelopathy in childhood. Dev Med Child Neurol. 28(2):198-204, 1986