Journal
SEMINARS IN NEUROLOGY
Volume 41, Issue 3, Pages 269-279Publisher
THIEME MEDICAL PUBL INC
DOI: 10.1055/s-0041-1725152
Keywords
myelopathy; autoimmune; myelitis; multiple sclerosis; neuromyelitis optica; neurosarcoidosis; MOG-related disease; ADEM; paraneoplastic; parainfectious
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Myelopathy refers to a group of disorders affecting the spinal cord, with a subgroup having autoimmune and inflammatory-based pathology. Symptoms can progress rapidly or have a more gradual onset, making prompt diagnosis crucial. For some patients, disabling symptoms may persist long-term.
Myelopathy is a broad term used to describe a heterogeneous group of disorders that affects the spinal cord; the focus of this article will be a subgroup of these disorders with an autoimmune and inflammatory-based pathology. Symptoms typically develop over hours or days and then worsen over a matter of days to weeks, but sometimes can have a more insidious or subacute presentation, which can make the diagnosis more puzzling. Despite relatively low incidence rates, almost a third of affected patients are left with severely disabling symptoms. Prompt recognition of the underlying etiology is essential so that a specific targeted therapy can be implemented for optimal outcomes. The authors discuss a systematic approach to immune-mediated myelopathies, with a focus on the unique characteristics of each that may aid in diagnosis.
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