Myelopathy
It is important not to mistake myelopathy for myelitis. Although both terms refer to spinal cord compromise due to a pathological event, myelopathy has multiple etiologies, while myelitis is used to refer to inflammatory or infectious processes - Ana María Granados Sánchez
HWN Suggests
Diagnostic Approach to Myelopathies
Compressive disease is the main cause of myelopathy in older patients. It has a chronic course and usually does not recur. High intensity signals in T2 images is explained by myelomalacia, gliosis, tethering damage, vascular or inflammatory edema, demyelination and vacuolar changes. Gadolinium enhancement is limited to the region of maximum compression. Kelley et al. found that none of the patients with compressive myelopathy improved with intravenous corticosteroids, while patients with inflammatory myelopathies did improve, invalidating the hypothesis of traumatic inflammatory demyelination.
Articles of Interest
What is a Myelopathy?
A myelopathy is a broad term used to describe conditions that result in damage or dysfunction in the spinal cord, meningeal, or perimenigeal spaces. These conditions can arise from various factors, such as traumatic injuries, vascular diseases, infections, inflammation, or autoimmune disorders, and they can lead to serious outcomes like quadriplegia, paraplegia, or sensory deficits. Early recognition and intervention are crucial to potentially reverse these effects. It’s important to differentiate myelopathy from myelitis; which specifically involves inflammation of the spinal cord and is considered a type of myelopathy. Myelopathies can be further classified into compressive causes (more common in older patients), and non-compressive causes; which encompass a wide range of potential underlying factors, including infections, toxins, metabolic issues, and paraneoplastic processes. Recognizing when to suspect myelopathy, understanding examination findings, and knowing when to order an MRI evaluation are essential skills for emergency physicians.
A Case Report of Nitrous Oxide-induced Myelopathy: An Unusual Cause of Weakness in an Emergency Department.
The use of recreational inhalant and the patient's occupation should be considered when a patient presents with weakness. Obtaining vitamin B and methylmalonic acid levels should be considered for diagnosis. However, NO-induced neuropathy can be seen in patients with normal vitamin B and methylmalonic levels and patients do not always have abnormal imaging findings.
Myelopathy - Sereece Snow
It turns out, part of Sereece’s spinal cord was crushed. Sereece says, “Dr. Goodwin showed me my MRI and where my vertebrae were destroyed. He took the time to explain everything and told me I needed surgery, preferably sooner rather than later. He said he may not be able to restore me back to fully-normal, and that I may still have pain, but he had to stop the progression of spinal cord damage.”
Surfer’s Myelopathy : Case Series and Literature Review
Surfer’s myelopathy is a rare nontraumatic spinal cord injury usually affecting novice surfers. Ischemic insult is thought to play a crucial role in the pathophysiology of this rare disease.
Surfer’s myelopathy without surfing: a report of two pediatric patients
Surfer’s myelopathy (SM) is a rare disorder described in subjects presenting with acute paraparesis while learning how to surf. It is thought to be secondary to spinal ischemia triggered by hyperextension. Spinal magnetic resonance imaging (MRI) shows changes consistent with spinal cord ischemia on T2-weighted and diffusion-weighted imaging (DWI).
Thoracic Myelopathy
The most common treatment for thoracic myelopathy is decompression surgery, though physical therapy and medications may also be used.
Resources
Myelopathy Matters
We are here to raise awareness of Myelopathy and to make myelopathy matter. Help us raise awareness.
Myelopathy.org
Myelopathy.org, the first global scientific and clinical charity for Degenerative Cervical Myelopathy.
