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2022-01-30T12:53:24Z

Text replacement - " species]]" to "]]"

← Older revision		Revision as of 12:53, 30 January 2022
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	**[[Zika virus]]		**[[Zika virus]]
	**[[Lyme disease]]		**[[Lyme disease]]
	**[[Mycoplasma ~~species~~]]		**[[Mycoplasma]]
	**[[Treponema pallidum]]		**[[Treponema pallidum]]
	*Paraneoplastic, most often secondary to [[small cell lung cancer]]		*Paraneoplastic, most often secondary to [[small cell lung cancer]]

Aidan: /* Etiology */

2020-07-29T14:18:19Z

Etiology

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	== Definition ==		==Definition==

	* Heterogeneous condition characterized by inflammation of the spinal cord		*Heterogeneous condition characterized by inflammation of the spinal cord

	== Etiology ==		==Etiology==

			*CNS disorders
	* Post-infectious
			**[[Multiple sclerosis]]
	* Post vaccination
			**[[Neuromyelitis optica]]
⚫	* Infectious
			**[[Acute disseminated encephalomyelitis]] (ADEM)
	** VZV
			**[[Myelin oligodendrocyte glyocprotein antibody-associated disorder]]
	** CMV
		⚫	*Systemic inflammatory disorders
	** Etc.
		⚫	**[[Sarcoidosis]]
⚫	* Systemic inflammatory ~~conditions~~
			**[[Sjögren syndrome]]
⚫	** Sarcoidosis
			**[[Systemic lupus erythematosus]]
	* Acquired demyelinating disease
			**Others: [[ankylosing spondylitis]], [[antiphospholipid antibody syndrome]], [[Behçet disease]], [[mixed connective tissue disease]], [[rheumatoid arthritis]], and [[systemic sclerosis]]
	** MS
		⚫	*Infectious
⚫	* Idiopathic
			**[[Enteroviruses]], especially D68 and EV71
			**[[West Nile virus]]
			**[[Herpesviridae]], including [[HSV]], [[VZV]], [[EBV]], [[CMV]], and [[HHV-6]]
			**[[HIV]]
			**[[HTLV-1]]
			**[[Zika virus]]
			**[[Lyme disease]]
			**[[Mycoplasma species]]
			**[[Treponema pallidum]]
			*Paraneoplastic, most often secondary to [[small cell lung cancer]]
			**Anti-Hu disease
			**Anti-CRMP5 disease
		⚫	*Idiopathic

	== Clinical ~~Presentation~~ ==		==Clinical Manifestations==

			*Presentation is either acute or subacute, usually starting with sensory changes, weakness, or pain
	* Motor and sensory deficits
			*Characterized by both motor and sensory deficits, with specific deficits depending on the spinal level of the lesion

	== Investigations ==		==Investigations==

	* MRI spine '''with gadolinium'''		*MRI spine '''with gadolinium''', showing characteristic T2 hyperintensity without evidence of cord compression
			*CSF showing pleocytosis

	== Diagnosis ==		==Diagnosis==

	* ~~Bilateral sensorimotor~~ and autonomic spinal cord dysfunction		*Sensorimotor and autonomic spinal cord dysfunction
	** ~~May~~ be asymmetric		**Generally bilateral but may be asymmetric
	* Clearly defined sensory level		*Clearly defined sensory level
			*Bilateral signs and symptoms
	* Progression peaking between 4h and 21d after onset		*Progression peaking between 4h and 21d after onset
	* Demonstration of spinal cord inflammation		*Demonstration of spinal cord inflammation
	** Cerebrospinal fluid with pleocytosis or increased IGG		**Cerebrospinal fluid with pleocytosis or increased IGG
	** MRI with gadolinium		**MRI with gadolinium
	* Exclusion of compressive, postradiation, neoplastic, and vascular causes		*Exclusion of compressive, postradiation, neoplastic, and vascular causes

	== Management ==		==Management==

	* Determine cause		*Determine cause
	* Consider high-dose steroids 1g/d x3-5 days		*Consider high-dose steroids 1g/d x3-5 days
	* Thromboembolism prophylaxis		*Thromboembolism prophylaxis
	* Symptom management for pain and spasticity		*Symptom management for pain and spasticity
	** Muscle relaxants		**Muscle relaxants
	* Rehab (PT/OT)		*Rehab (PT/OT)
	* Follow-up investigations		*Follow-up investigations
	** Repeat MRI		**Repeat MRI

	[[Category:Neurology]]		[[Category:Neurology]]

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2020-07-04T01:17:59Z

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New page

== Definition ==

* Heterogeneous condition characterized by inflammation of the spinal cord

== Etiology ==

* Post-infectious
* Post vaccination
* Infectious
** VZV
** CMV
** Etc.
* Systemic inflammatory conditions
** Sarcoidosis
* Acquired demyelinating disease
** MS
* Idiopathic

== Clinical Presentation ==

* Motor and sensory deficits

== Investigations ==

* MRI spine '''with gadolinium'''

== Diagnosis ==

* Bilateral sensorimotor and autonomic spinal cord dysfunction
** May be asymmetric
* Clearly defined sensory level
* Progression peaking between 4h and 21d after onset
* Demonstration of spinal cord inflammation
** Cerebrospinal fluid with pleocytosis or increased IGG
** MRI with gadolinium
* Exclusion of compressive, postradiation, neoplastic, and vascular causes

== Management ==

* Determine cause
* Consider high-dose steroids 1g/d x3-5 days
* Thromboembolism prophylaxis
* Symptom management for pain and spasticity
** Muscle relaxants
* Rehab (PT/OT)
* Follow-up investigations
** Repeat MRI

[[Category:Neurology]]

Transverse myelitis - Revision history

Aidan: Text replacement - " species]]" to "]]"

Aidan: /* Etiology */

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