Neurol. praxi. 2011;12(1):37-42

Acute myelitis - etiology, diagnosis and treatment

doc.MUDr.Peter Špalek, PhD.

Centrum pre neuromuskulárne ochorenia

The differential diagnosis of acute myelitis is broad. Therefore, neurologists must be aware of many potential etiologies for acute

myelopathy and be able to provide an ordered and efficient diagnostic approach based on patient´s history, clinical examination and

magnetic resonance imaging (MRI) findigs. When faced with a patient with an acute myelopathy, excluding an acute compressive

cause by MRI is of highest priority. Having excluded a compressive cause and having found an intramedullary spinal cord lesion, the

diagnosis of an infectious or inflammatory myelopathy becomes a primary consideration. Detailed history, clinical presentation,

focused investigations and treatment of infectious and inflammatory myelopathies are reviewed. Infectious myelitis are caused

by viral, bacterial, and rarely by fungal or parasitic agents. Acute noninfectious inflammatory myelopathies were previously often

categorized as idiopathic acute transverse myelitis. Advances in neuroimaging and in neuroimmunology have allowed in many

cases more specific diagnosis, such as neuromyelitis optica, multiple sclerosis, acute disseminated encephalomyelitis, postvaccinial

or postinfectious myelitis, inflammatory myelopathies associated with systemic autoimmune diseases and acute paraneoplastic

myelopathies. This paper focuses on a prompt ordered approach in diagnostic evaluation and on treatment of infectious and inflammatory

causes of acute myelitis.

Keywords: infectious myelitis, inflammatory myelopathies, diagnostic algorithm, treatment

Published: February 18, 2011  Show citation