An approach to the diagnosis of acute transverse myelitis
An approach to the diagnosis of acute transverse myelitis
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DOI：
10.1055/s-2007-1019132
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发表时间：
2008-02-01
影响因子：
2.7
通讯作者：
Weinshenker, Brian G.
中科院分区：
文献类型：
--
作者：
Jacob, Anu;Weinshenker, Brian G.
急性炎性横肌萎缩症（ATM）的鉴别诊断是广泛的。因此，医生必须了解急性脊髓病的许多潜在病因，并应根据患者的临床病史、检查和磁共振成像（MRI）结果，寻求一种有序、有效和经济有效的诊断方法。本文综述了非压迫性脊髓病的临床、免疫学和放射学表现，以及这些表现如何用于区分脱髓鞘、感染、其他炎症、血管、肿瘤和副肿瘤病因。我们还审查了脱髓鞘疾病患者ATM进一步发作的预测因素。我们讨论的诊断线索和陷阱并不罕见的临床情况下，假定“脊髓病与正常的MRI。“最后，我们提出了一个诊断和治疗急性脊髓病的算法。
The differential diagnosis of acute inflammatory transverse myelitis (ATM) is broad. Therefore, physicians must be aware of the many potential etiologies for acute myelopathy, and should pursue an ordered, efficient, and cost-effective approach to the diagnosis based on the patient's clinical history, examination, and magnetic resonance imaging (MRI) findings. Clinical, immunological, and radiological findings of non-compressive myelopathies are reviewed, as are how these findings can be used to distinguish between demyelinating, infectious, other inflammatory, vascular, neoplastic, and paraneoplastic etiologies. We also review predictors of further episodes of ATM in patients with demyelinating disorders. We discuss the diagnostic clues and pitfalls of the not uncommon clinical scenario of a presumed "myelopathy with normal MRI." Finally, we suggest an algorithm for the diagnosis and management of acute myelopathies.