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Area of Science:

  • Pediatric Neurology
  • Neuroradiology
  • Spinal Cord Imaging

Background:

  • Acute myelopathy in children presents with sensory, motor, or bowel/bladder dysfunction.
  • Magnetic Resonance Imaging (MRI) of the neuraxis with contrast is crucial for diagnosis.
  • Longitudinally extensive transverse myelitis is classically associated with Neuromyelitis Optica (NMO), but other causes exist.

Purpose of the Study:

  • To review differential diagnoses for longitudinally extensive spinal cord signal abnormalities in pediatric patients.
  • To highlight the role of radiologists in identifying diverse etiologies of myelopathy in children.

Main Methods:

  • Pictorial essay format reviewing imaging findings.
  • Focus on MRI demonstrating signal abnormalities within the spinal cord.
  • Discussion of various etiological categories presenting as myelopathy.

Main Results:

  • MRI frequently shows spinal cord signal abnormalities in pediatric acute myelopathy.
  • Longitudinally extensive abnormalities can stem from multiple causes beyond NMO.
  • Differential diagnoses include inflammatory, infectious, vascular, metabolic, and neurodegenerative conditions.

Conclusions:

  • Radiologists must be aware of the broad spectrum of diseases causing longitudinally extensive spinal cord signal abnormalities in children.
  • Accurate diagnosis aids in appropriate management of pediatric myelopathy.
  • Distinguishing these findings from trauma-related injuries is essential.