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spinal cord disease; myelopathy (disease/disorder primarily affecting spinal cord)
Etiology:
- spinal cord compression
- non-compressive myelopathy
a) demyelination
- multiple sclerosis
- neuromyelitis optica
- transverse myelitis
b) inflammation
c) infection
d) nutritional
- vitamin B12 deficiency
- copper deficiency
e) toxic/metabolic
f) vascular
- infarctions
- generally involve anterior spinal artery
- result in sudden weakness, sparing sensation
- dural arteriovenous fistula
g) genetic
Clinical manifestations:
- often associated with a disinct sensory level below which sensation may be altered or lost
- this sensory level often correlates with anatomic level of spinal cord injury
- corticospinal tract injury
- spastic paresis or paralysis
- weakness, hyperreflexia, muscle spasticity
- extensor plantar response (Babinski's sign)
- involvement of the lower cord & nerve roots
- cauda equina syndrome
Radiology:
- spinal cord imaging (magnetic resonance imaging)
- directed by sensory level from neurologic examination
Related
spinal cord compression; compressive myelopathy
Specific
anterior spinal artery compression syndrome
cauda equina syndrome
cervical myelopathy
Guillain-Barre syndrome (GBS)
intraspinal abscess
myelitis
neurosyphilis (dementia paralytica, syphilitic paresis)
progressive bulbar paralysis (Duchenne syndrome)
spinal cord injury (SCI)
spinal cord lesion
spinal dural arteriovenous fistula
spinal shock
spinal stenosis
subacute combined degeneration of spinal cord; Lichtheim's disease; Putnam-Dana Syndrome
syringomyelia
transverse myelopathy
vacuolar myelopathy
General
central nervous system (CNS) disease
spine disease; vertebral disorder
References
- de Seze J et al
Acute myelopathies: Clinical, laboratory and outcome profiles
in 79 cases.
Brain. 2001 Aug;124(Pt 8):1509-21.
PMID: 11459743
- Schmalstieg WF, Weinshenker BG.
Approach to acute or subacute myelopathy.
Neurology. 2010 Nov 2;75(18 Suppl 1):S2-8.
PMID: 21041766
- Medical Knowledge Self Assessment Program (MKSAP) 17, 18, 19.
American College of Physicians, Philadelphia 2015, 2018, 2021.
- Medical Knowledge Self Assessment Program (MKSAP) 19
Board Basics. An Enhancement to MKSAP19.
American College of Physicians, Philadelphia 2022