Uncommon inflammatory/immune-related myelopathies

Area of Science:

• Neurology
• Immunology
• Radiology

Background:

• Immune-mediated myelopathies present a broad differential diagnosis with overlapping clinical features.
• Specific presentations can suggest particular etiologies, but accurate diagnosis remains challenging.

Purpose of the Study:

• To review the pathophysiology, clinical presentation, imaging findings, and treatment outcomes of uncommon immune-mediated myelopathies.
• To highlight the role of biomarkers in improving diagnosis and understanding myelitis.

Main Methods:

• Literature review focusing on immune-mediated myelopathies.
• Analysis of clinical manifestations, spine MRI characteristics (lesion length, location, enhancement patterns), and antibody biomarkers.

Main Results:

• Spine MRI findings, including lesion characteristics and gadolinium enhancement patterns, are crucial for differential diagnosis and excluding compressive causes.
• Discovery of antibodies such as aquaporin-4-IgG and MOG-IgG has advanced the understanding of myelitis pathophysiology and diagnosis.

Conclusions:

• A comprehensive approach integrating clinical, imaging, and serological data is essential for diagnosing uncommon immune-mediated myelopathies.
• Understanding specific antibody biomarkers improves diagnostic accuracy and therapeutic strategies for myelitis.