[Non-traumatic acute transverse spinal cord syndromes]

Area of Science:

• Neurology
• Spinal Cord Syndromes
• Differential Diagnosis

Background:

• Acute transverse spinal cord syndromes present with rapid onset neurological deficits.
• Differential diagnosis includes compressive myelopathy, inflammatory myelitis, and vascular pathologies.
• Spinal shock, characterized by flaccid paresis and areflexia, is a common initial presentation.

Purpose of the Study:

• To outline the differential diagnosis of non-traumatic, acute transverse spinal cord syndromes.
• To categorize spinal cord syndromes based on affected structures and underlying etiologies.
• To highlight key clinical features aiding in diagnosis and localization.

Main Methods:

• Review of clinical presentations and diagnostic considerations for acute spinal cord syndromes.
• Categorization of syndromes based on anatomical involvement (anterior, long pathway, Brown-Séquard's).
• Discussion of infectious and non-infectious inflammatory causes, including autoimmune and connective tissue diseases.

Main Results:

• Key differentials include compressive myelopathy (hematomas, tumors), inflammatory myelitis (infectious, autoimmune), and vascular myelopathies.
• Syndromes are classified by affected pathways, such as anterior spinal cord syndromes, long pathway syndromes, and Brown-Séquard's syndrome.
• Infectious myelitis involves neurotropic viruses or mycoplasmata, while non-infectious causes include MS, ADEM, and neuromyelitis optica.

Conclusions:

• Accurate differential diagnosis of acute transverse spinal cord syndromes is essential for timely and appropriate treatment.
• Understanding the specific patterns of neurological deficits aids in localizing the spinal cord lesion.
• A broad range of etiologies, from vascular insults to inflammatory and infectious processes, must be considered.