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KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Clinical Issues
Diagnostic Checklist
TERMINOLOGY
Abbreviations
- Acute transverse myelitis (ATM)
- Acute flaccid myelitis (AFM)
Definitions
- Acute inflammatory insult of spinal cord due to direct viral infection or postviral immunologic attack
IMAGING
General Features
CT Findings
MR Findings
Nonvascular Interventions
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
- Helfferich J et al: Acute flaccid myelitis and enterovirus D68: lessons from the past and present. Eur J Pediatr. 178(9):1305-15, 2019
- Rodríguez Y et al: Guillain-Barré syndrome, transverse myelitis and infectious diseases. Cell Mol Immunol. 15(6):547-62, 2018
- Hopkins SE: Acute flaccid myelitis: etiologic challenges, diagnostic and management considerations. Curr Treat Options Neurol. 19(12):48, 2017
- Division of Viral Diseases, National Centers for Immunization and Respiratory Diseases, CDC; Division of Vector-Borne Diseases, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, CDC; Children's Hospital Colorado; Council of State and Territorial Epidemiologists: Notes from the field: acute flaccid myelitis among persons aged ≤21 years - United States, august 1-november 13, 2014. MMWR Morb Mortal Wkly Rep. 63(53):1243-4, 2015
- 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, 2015
- Sejvar JJ et al: Delayed-onset and recurrent limb weakness associated with West Nile virus infection. J Neurovirol. 16(1):93-100, 2010
- Blakely PK et al: Disrupted glutamate transporter expression in the spinal cord with acute flaccid paralysis caused by West Nile virus infection. J Neuropathol Exp Neurol. 68(10):1061-72, 2009
- Heerlein K et al: Aquaporin-4 antibody positive longitudinally extensive transverse myelitis following varicella zoster infection. J Neurol Sci. 276(1-2):184-6, 2009
- Kincaid O et al: Viral myelitis: an update. Curr Neurol Neurosci Rep. 6(6):469-74, 2006
- Marjelund S et al: Gadolinium enhancement of cauda equina: a new MR imaging finding in the radiculitic form of tick-borne encephalitis. AJNR Am J Neuroradiol. 27(5):995-7, 2006
- Fujimoto H et al: Epstein-Barr virus infections of the central nervous system. Intern Med. 42(1):33-40, 2003
- Jeha LE et al: West Nile virus infection: a new acute paralytic illness. Neurology. 61(1):55-9, 2003
- Zandman-Goddard G et al: Transverse myelitis associated with chronic hepatitis C. Clin Exp Rheumatol. 21(1):111-3, 2003
- Karacostas D et al: Cytomegalovirus-associated transverse myelitis in a non-immunocompromised patient. Spinal Cord. 40(3):145-9, 2002
- Chen CY et al: Acute flaccid paralysis in infants and young children with enterovirus 71 infection: MR imaging findings and clinical correlates. AJNR Am J Neuroradiol. 22(1):200-5, 2001
- Gorson KC et al: Nonpoliovirus poliomyelitis simulating Guillain-Barre syndrome. Arch Neurol. 58(9):1460-4, 2001
- McMinn P et al: Neurological manifestations of enterovirus 71 infection in children during an outbreak of hand, foot, and mouth disease in Western Australia. Clin Infect Dis. 32(2):236-42, 2001
- Andersen O: Myelitis. Curr Opin Neurol. 13(3):311-6, 2000
- Gruhn B et al: Successful treatment of Epstein-Barr virus-induced transverse myelitis with ganciclovir and cytomegalovirus hyperimmune globulin following unrelated bone marrow transplantation. Bone Marrow Transplant. 24(12):1355-8, 1999
- Haanpaa M et al: CSF and MRI findings in patients with acute herpes zoster. Neurology. 51(5):1405-11, 1998
- Ku B et al: Acute transverse myelitis caused by Coxsackie virus B4 infection: a case report. J Korean Med Sci. 13(4):449-53, 1998
- Nakajima H et al: Herpes simplex virus myelitis: clinical manifestations and diagnosis by the polymerase chain reaction method. Eur Neurol. 39(3):163-7, 1998
- Salonen O et al: Myelitis associated with influenza A virus infection. J Neurovirol. 3(1):83-5, 1997
- Cheshire WP et al: Spinal cord infarction: etiology and outcome. Neurology. 47(2):321-30, 1996
- de Silva SM et al: Zoster myelitis: improvement with antiviral therapy in two cases. Neurology. 47(4):929-31, 1996
- Ebo DG et al: Herpes zoster myelitis occurring during treatment for systemic lupus erythematosus. J Rheumatol. 23(3):548-50, 1996
- Moulignier A et al: AIDS-associated cytomegalovirus infection mimicking central nervous system tumors: a diagnostic challenge. Clin Infect Dis. 22(4):626-31, 1996
- Breningstall GN et al: Acute transverse myelitis and brainstem encephalitis associated with hepatitis A infection. Pediatr Neurol. 12(2):169-71, 1995
- 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
- Caldas C et al: Case report: transverse myelitis associated with Epstein-Barr virus infection. Am J Med Sci. 307(1):45-8, 1994
- Gilden DH et al: Varicella-zoster virus myelitis: an expanding spectrum. Neurology. 44(10):1818-23, 1994
- Kyllerman MG et al: PCR diagnosis of primary herpesvirus type I in poliomyelitis-like paralysis and respiratory tract disease. Pediatr Neurol. 9(3):227-9, 1993
- Chang CM et al: Postinfectious myelitis, encephalitis and encephalomyelitis. Clin Exp Neurol. 29:250-62, 1992
- Cumming WJ: Myelitis and toxic, inflammatory and infectious disorders. Curr Opin Neurol Neurosurg. 5(4):549-53, 1992
- Dawson DM et al: Acute nontraumatic myelopathies. Neurol Clin. 9(3):585-603, 1991
- Hwang YM et al: A case of herpes zoster myelitis: positive magnetic resonance imaging finding. Eur Neurol. 31(3):164-7, 1991
- Iwamasa T et al: Acute ascending necrotizing myelitis in Okinawa caused by herpes simplex virus type 2. Virchows Arch A Pathol Anat Histopathol. 418(1):71-5, 1991
- Power C et al: Pathological and molecular biological features of a myelopathy associated with HTLV-1 infection. Can J Neurol Sci. 18(3):352-5, 1991
- Awerbuch G et al: Demonstration of acute post-viral myelitis with magnetic resonance imaging. Pediatr Neurol. 3(6):367-9, 1987
- Wiley CA et al: Acute ascending necrotizing myelopathy caused by herpes simplex virus type 2. Neurology. 37(11):1791-4, 1987
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Clinical Issues
Diagnostic Checklist
TERMINOLOGY
Abbreviations
- Acute transverse myelitis (ATM)
- Acute flaccid myelitis (AFM)
Definitions
- Acute inflammatory insult of spinal cord due to direct viral infection or postviral immunologic attack
IMAGING
General Features
CT Findings
MR Findings
Nonvascular Interventions
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
- Helfferich J et al: Acute flaccid myelitis and enterovirus D68: lessons from the past and present. Eur J Pediatr. 178(9):1305-15, 2019
- Rodríguez Y et al: Guillain-Barré syndrome, transverse myelitis and infectious diseases. Cell Mol Immunol. 15(6):547-62, 2018
- Hopkins SE: Acute flaccid myelitis: etiologic challenges, diagnostic and management considerations. Curr Treat Options Neurol. 19(12):48, 2017
- Division of Viral Diseases, National Centers for Immunization and Respiratory Diseases, CDC; Division of Vector-Borne Diseases, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, CDC; Children's Hospital Colorado; Council of State and Territorial Epidemiologists: Notes from the field: acute flaccid myelitis among persons aged ≤21 years - United States, august 1-november 13, 2014. MMWR Morb Mortal Wkly Rep. 63(53):1243-4, 2015
- 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, 2015
- Sejvar JJ et al: Delayed-onset and recurrent limb weakness associated with West Nile virus infection. J Neurovirol. 16(1):93-100, 2010
- Blakely PK et al: Disrupted glutamate transporter expression in the spinal cord with acute flaccid paralysis caused by West Nile virus infection. J Neuropathol Exp Neurol. 68(10):1061-72, 2009
- Heerlein K et al: Aquaporin-4 antibody positive longitudinally extensive transverse myelitis following varicella zoster infection. J Neurol Sci. 276(1-2):184-6, 2009
- Kincaid O et al: Viral myelitis: an update. Curr Neurol Neurosci Rep. 6(6):469-74, 2006
- Marjelund S et al: Gadolinium enhancement of cauda equina: a new MR imaging finding in the radiculitic form of tick-borne encephalitis. AJNR Am J Neuroradiol. 27(5):995-7, 2006
- Fujimoto H et al: Epstein-Barr virus infections of the central nervous system. Intern Med. 42(1):33-40, 2003
- Jeha LE et al: West Nile virus infection: a new acute paralytic illness. Neurology. 61(1):55-9, 2003
- Zandman-Goddard G et al: Transverse myelitis associated with chronic hepatitis C. Clin Exp Rheumatol. 21(1):111-3, 2003
- Karacostas D et al: Cytomegalovirus-associated transverse myelitis in a non-immunocompromised patient. Spinal Cord. 40(3):145-9, 2002
- Chen CY et al: Acute flaccid paralysis in infants and young children with enterovirus 71 infection: MR imaging findings and clinical correlates. AJNR Am J Neuroradiol. 22(1):200-5, 2001
- Gorson KC et al: Nonpoliovirus poliomyelitis simulating Guillain-Barre syndrome. Arch Neurol. 58(9):1460-4, 2001
- McMinn P et al: Neurological manifestations of enterovirus 71 infection in children during an outbreak of hand, foot, and mouth disease in Western Australia. Clin Infect Dis. 32(2):236-42, 2001
- Andersen O: Myelitis. Curr Opin Neurol. 13(3):311-6, 2000
- Gruhn B et al: Successful treatment of Epstein-Barr virus-induced transverse myelitis with ganciclovir and cytomegalovirus hyperimmune globulin following unrelated bone marrow transplantation. Bone Marrow Transplant. 24(12):1355-8, 1999
- Haanpaa M et al: CSF and MRI findings in patients with acute herpes zoster. Neurology. 51(5):1405-11, 1998
- Ku B et al: Acute transverse myelitis caused by Coxsackie virus B4 infection: a case report. J Korean Med Sci. 13(4):449-53, 1998
- Nakajima H et al: Herpes simplex virus myelitis: clinical manifestations and diagnosis by the polymerase chain reaction method. Eur Neurol. 39(3):163-7, 1998
- Salonen O et al: Myelitis associated with influenza A virus infection. J Neurovirol. 3(1):83-5, 1997
- Cheshire WP et al: Spinal cord infarction: etiology and outcome. Neurology. 47(2):321-30, 1996
- de Silva SM et al: Zoster myelitis: improvement with antiviral therapy in two cases. Neurology. 47(4):929-31, 1996
- Ebo DG et al: Herpes zoster myelitis occurring during treatment for systemic lupus erythematosus. J Rheumatol. 23(3):548-50, 1996
- Moulignier A et al: AIDS-associated cytomegalovirus infection mimicking central nervous system tumors: a diagnostic challenge. Clin Infect Dis. 22(4):626-31, 1996
- Breningstall GN et al: Acute transverse myelitis and brainstem encephalitis associated with hepatitis A infection. Pediatr Neurol. 12(2):169-71, 1995
- 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
- Caldas C et al: Case report: transverse myelitis associated with Epstein-Barr virus infection. Am J Med Sci. 307(1):45-8, 1994
- Gilden DH et al: Varicella-zoster virus myelitis: an expanding spectrum. Neurology. 44(10):1818-23, 1994
- Kyllerman MG et al: PCR diagnosis of primary herpesvirus type I in poliomyelitis-like paralysis and respiratory tract disease. Pediatr Neurol. 9(3):227-9, 1993
- Chang CM et al: Postinfectious myelitis, encephalitis and encephalomyelitis. Clin Exp Neurol. 29:250-62, 1992
- Cumming WJ: Myelitis and toxic, inflammatory and infectious disorders. Curr Opin Neurol Neurosurg. 5(4):549-53, 1992
- Dawson DM et al: Acute nontraumatic myelopathies. Neurol Clin. 9(3):585-603, 1991
- Hwang YM et al: A case of herpes zoster myelitis: positive magnetic resonance imaging finding. Eur Neurol. 31(3):164-7, 1991
- Iwamasa T et al: Acute ascending necrotizing myelitis in Okinawa caused by herpes simplex virus type 2. Virchows Arch A Pathol Anat Histopathol. 418(1):71-5, 1991
- Power C et al: Pathological and molecular biological features of a myelopathy associated with HTLV-1 infection. Can J Neurol Sci. 18(3):352-5, 1991
- Awerbuch G et al: Demonstration of acute post-viral myelitis with magnetic resonance imaging. Pediatr Neurol. 3(6):367-9, 1987
- Wiley CA et al: Acute ascending necrotizing myelopathy caused by herpes simplex virus type 2. Neurology. 37(11):1791-4, 1987
