Transverse Myelitis - 26/11/12

Doi : 10.1016/j.ncl.2012.09.008

Shin C. Beh, MD ^a, Benjamin M. Greenberg, MHS, MD ^a, Teresa Frohman, PA-C ^a, Elliot M. Frohman, MD, PhD ^a,^b,^⁎
^a Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, 5323, Harry Hines Blvd, Dallas, TX 75390, USA
^b Department of Ophthalmology, University of Texas Southwestern Medical Center, 5323, Harry Hines Blvd, Dallas, TX 75390, USA

Corresponding author. Multiple Sclerosis Clinical Care Center, UT Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75235.

Résumé

Transverse myelitis (TM) includes a pathobiologically heterogeneous syndrome characterized by acute or subacute spinal cord dysfunction resulting in paresis, a sensory level, and autonomic (bladder, bowel, and sexual) impairment below the level of the lesion. Etiologies for TM can be broadly classified as parainfectious, paraneoplastic, drug/toxin-induced, systemic autoimmune disorders, and acquired demyelinating diseases. We discuss the clinical evaluation, workup, and acute and long-term management of patients with TM. Additionally, we briefly discuss various disease entities that may cause TM and their salient distinguishing features, as well as disorders that may mimic TM.

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Keywords : Transverse myelitis, Longitudinally-extensive transverse myelitis, Multiple sclerosis, Lupus myelopathy, Sjogren’s myelopathy, Idiopathic transverse myelitis

Plan

Disclosures & Conflicts of Interest: Dr Beh is the recipient of the Biogen Idec Clinical MS Fellowship award. Dr Greenberg has received honoraria from EMD Serono, American Academy of Neurology, Multiple Sclerosis Association of America, and National Multiple Sclerosis Society; consulting fees from Acorda, DioGenix, and Greater Good Foundation; and grants from Amplimmune, Accelerated Cure Project, and Guthy Jackson Charitable Foundation. Teresa Frohman is a consultant and speaker for Biogen Idec and Novartis. Dr Frohman has received speaker fees from Biogen Idec, Teva Neuroscience, and Acorda Pharmaceuticals, and consulting fees from Biogen Idec, Teva Neurosciences, Abbott, Acorda Therapeutics, and Novartis.