Acute transverse myelitis: A practical reappraisal
Acute transverse myelitis: A practical reappraisal
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DOI：
10.1016/j.autrev.2009.04.005
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发表时间：
2009-12-01
影响因子：
13.6
通讯作者：
Sa, Maria Jose
中科院分区：
文献类型：
--
作者：
Sa, Maria Jose
急性横断面脊髓炎（ATM）是一种炎症性，通常是特发性脊髓疾病，是引起脊髓横断面综合征的各种疾病的一个亚群。特发性ATM是根据既定标准诊断的，主要是确保双侧症状和体征的临床表现归因于脊髓疾病，通过磁共振成像和脑脊液检查存在局灶性脊髓炎症，并排除许多疾病，特别是脊髓压迫和“疾病相关ATM”，如干燥病。特发性ATM患者有急性或亚急性发作的运动、感觉和自主神经功能障碍，在4小时至21天内进展至最低点，大多数病例完全或部分恢复。需要用皮质类固醇进行紧急治疗以停止炎症以及早期适当的对症治疗。最近新发现的生物标志物区分了特异性炎症性和自身免疫性脊髓疾病，即副肿瘤脊髓炎和视神经脊髓炎光谱疾病，其诊断对建立治疗策略至关重要。(C) 2009 Elsevier B.V.版权所有
Acute transverse myelitis (ATM), a subgroup of various conditions that cause transverse spinal cord syndromes, is an inflammatory and usually idiopathic spinal cord disease. Idiopathic ATM is diagnosed according to established criteria which mainly assure a clinical picture of bilateral symptoms and signs attributable to spinal cord disease, existence of focal cord inflammation by magnetic resonance imaging and cerebrospinal fluid studies, and exclusion of many diseases, especially cord compression and "disease-associated ATM", as Sjogren disease. Patients with idiopathic ATM have motor, sensory and autonomic dysfunctions with acute or subacute onset, progressing to nadir in 4 h to 21 days, with full or partial recovery in most cases. Emergent treatment to halt inflammation with corticosteroids is required as well as early appropriate symptomatic therapies. Recent discovery of novel biomarkers has set apart specific inflammatory and autoimmune myelopathies, namely paraneoplastic myelitis and neuromyelitis optica spectrum diseases, the diagnosis of which is crucial to establish therapeutic strategies. (C) 2009 Elsevier B.V. All rights reserved.