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Published on: August 21, 2017
[Transverse myelitis]
1Klinika Neurologii, Uniwersytet Medyczny w Białymstoku.
Abstract:
Transverse myelitis is a disease with various pathogenesis. It leads to a partial or total transverse lesion of the spinal cord structures resulting in an acute or subacute: motor (paralysis or paresis), sensory (most often with sensory level) and autonomic symptoms and signs. Its etiology is complex and sometimes difficult to establish explicitly. The most frequent reason of transverse myelitis is infection, but there are other factors like: postinfectious, neoplastic, paraneoplastic, demyelinating, immunological (connective tissue diseases), vascular and others. Idiopathic transverse myelitis accounts for about 10-40% of cases, and despite thorough diagnostics its aetiology cannot be established. Transeverse myelitis has been known for years, but it still poses a big problem both diagnostically and therapeuthically. Its course is frequently serious leading to persistent neurological damage and permanent disability. Diagnostic methods of choice are spinal cord MRI and CSF examination with assessment of oligoclonal bands, biomarkers of inflammatory process, 14-3-3 protein and neuronal specific enolase. Its treatment is determined by established aetiology. Many inconsistencies, no clear cut definition of the disease and lack of diagnostic criteria are being discussed by the group of experts working in Transverse Myelitis Consortium Group.
Insights
Transverse myelitis, a spinal cord disorder, presents with diverse causes and symptoms like paralysis and sensory loss. Early diagnosis and etiology-specific treatment are crucial for managing this condition and preventing permanent disability.
Area of Science:
- Neurology
- Immunology
- Infectious Diseases
Context:
- Transverse myelitis involves spinal cord inflammation affecting motor, sensory, and autonomic functions.
- Etiology is complex, ranging from infections and demyelination to immunological and neoplastic causes, with idiopathic cases comprising 10-40%.
Purpose:
- To outline the diverse pathogenesis, clinical manifestations, and diagnostic challenges of transverse myelitis.
- To highlight current diagnostic modalities and the etiological basis for treatment decisions.
Summary:
- Transverse myelitis causes acute or subacute spinal cord lesions leading to significant neurological deficits.
- Diagnostic approaches include spinal cord MRI and CSF analysis for biomarkers.
- Treatment is etiology-dependent, yet challenges in definition and criteria persist.
Impact:
- Understanding the varied causes and diagnostic complexities of transverse myelitis is vital for effective patient management.
- Improved diagnostic criteria and treatment strategies are needed to mitigate the risk of persistent neurological damage and disability.
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