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- W2316686438 abstract "Objective: To provide an MRI-based algorithm that would facilitate diagnosis of chronic myelopathy. Background Differential diagnosis of adult-onset chronic myelopathy is broad and patients with this syndrome can present a diagnostic challenge for the clinician with resultant delay in diagnosis and treatment. Several algorithms for evaluation of acute transverse myelitis have been proposed, but there has been less attention to progressive myelopathies (>6 months duration). Spinal MRI is an indispensible part of myelopathy work-up and can be used to organize the differential diagnosis. Design/Methods: We searched the English-language literature through PubMed for cases of adult-onset chronic myelopathy (spastic para- or quadra-paresis that progresses over a period of six months or longer) with over 50 different entities identified. We develop a comprehensive practical algorithm to diagnosis of chronic myelopathy based on characteristics of spinal MRI. Results: We propose to organize the differential diagnosis based on six spinal MRI patterns: 1. compressive lesions; 2. non-compressive extramedullary lesions; 3. intrinsic cord lesions; 4. longitudinal, tract-specific cord lesions; 5. diffuse cord atrophy; 6. apparently normal spinal MRI. A comprehensive differential diagnosis is generated for each MRI pattern (with some degree of overlap). Imaging examples of specific conditions for each of the MRI patterns are provided. Conclusions: Differential diagnosis of adult-onset chronic progressive myelopathy may be organized according to 6 major spinal MRI patterns. The proposed approach could facilitate the diagnosis of specific etiology of chronic myelopathy in clinical practice. Disclosure: Dr. Zhovtis has nothing to disclose. Dr. Howard has nothing to disclose. Dr. Herbert has received personal compensation for activities with Biogen Idec, Teva Neuroscience, Serono, Inc., and Bayer Pharmaceuticals Corporation as a consultant.Dr. Herbert has received research support from Teva Neuroscience, Novartis, Biogen Idec, BioMS, and INC Research. Dr. Kister has nothing to disclose." @default.
- W2316686438 created "2016-06-24" @default.
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- W2316686438 date "2012-04-22" @default.
- W2316686438 modified "2023-10-14" @default.
- W2316686438 title "Differential Diagnosis of Adult-Onset Chronic Myelopathy: MRI-Based Approach (P02.145)" @default.
- W2316686438 doi "https://doi.org/10.1212/wnl.78.1_meetingabstracts.p02.145" @default.
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