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Acute myelopathy presents a diagnostic challenge due to varied causes and overlapping symptoms. This review offers a simplified approach to identifying acute spinal cord conditions and their origins.

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Area of Science:

  • Neurology
  • Spinal Cord Pathology

Background:

  • Myelopathy involves spinal cord pathology with diverse causes.
  • Classification into acute, subacute, or chronic myelopathy is based on symptom progression time.
  • Acute myelopathy, with symptoms peaking within 21 days, poses diagnostic difficulties due to heterogeneous pathogenesis and overlapping presentations.

Purpose of the Study:

  • To provide a simplified diagnostic algorithm for acute myelopathy.
  • To outline clinical and imaging features of common acute myelopathy etiologies in adults.

Main Methods:

  • Review of literature on acute myelopathy.
  • Development of a simplified differential diagnosis approach.
  • Description of clinical and imaging characteristics of main etiologies.

Main Results:

  • Acute myelopathy requires categorization based on the time to maximum deficit.
  • Differential diagnosis is complicated by varied pathogenesis and similar clinical/imaging findings.
  • Recently identified antibody-mediated myelitis and its mimics are included.

Conclusions:

  • A simplified approach is valuable for timely diagnosis of acute myelopathy.
  • Understanding key clinical and imaging features aids in identifying specific etiologies.
  • This review aids clinicians in navigating the complexities of acute spinal cord conditions.