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[Nosology and etiologies of acute longitudinally extensive transverse myelitis]

N Collongues1, C Papeix2, H Zéphir3

  • 1Département de neurologie, hôpital universitaire de Strasbourg, 1, avenue Molière, 67200 Strasbourg, France.

Revue Neurologique
|November 26, 2013
PubMed

Insights

Acute transverse myelitis, now defined as longitudinally extensive transverse myelitis (LETM), requires a new classification. Experts propose a refined definition and diagnostic approach for this condition.

Area of Science:

  • Neurology
  • Radiology

Context:

  • Acute transverse myelitis (ATM) historically lacked standardized definitions, relying on clinical criteria.
  • The advent of MRI and identification of neuromyelitis optica (NMO) in 2004 refined myelitis diagnostics.
  • Longitudinally extensive transverse myelitis (LETM) is defined by MRI showing T2 lesions spanning ≥3 vertebral segments.

Purpose:

  • To address limitations in the current definition of LETM.
  • To clarify the etiology and nosology of LETM.
  • To propose a new, expert-validated definition and diagnostic strategy for LETM.

Summary:

  • A national survey was conducted to re-evaluate LETM definitions and etiologies.
  • Proposed diagnostic pathways include first- and second-intention examinations based on clinical context.
  • Identifies infectious, inflammatory, and paraneoplastic causes, emphasizing the need for rapid etiological determination.

Impact:

  • Facilitates accurate diagnosis and timely, appropriate treatment for LETM.
  • Improves patient outcomes by addressing severe underlying causes promptly.
  • Establishes a clearer framework for understanding and managing LETM in clinical practice.
Keywords:
Anti-AQP4 antibodyAnticorps anti-AQP4Longitudinally transverse acute muélitisMultiple sclerosisMyélite transverseMyélite transverse longitudinalement étendueNeuromyelitis opticaNeuromyélite optiqueSclérose en plaquesTransverse myelitis

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