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Semin Neurol 2021; 41(05): 511-529
DOI: 10.1055/s-0041-1733792
Review Article

Evaluation and Management of Acute Myelopathy

Elia Sechi
1   Department of Neurology, Mayo Clinic, Rochester, Minnesota
,
Eoin P. Flanagan 
1   Department of Neurology, Mayo Clinic, Rochester, Minnesota
2   Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
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Abstract

Acute myelopathies are spinal cord disorders characterized by a rapidly progressive course reaching nadir within hours to a few weeks that may result in severe disability. The multitude of underlying etiologies, complexities in confirming the diagnosis, and often unforgiving nature of spinal cord damage have always represented a challenge. Moreover, certain slowly progressive myelopathies may present acutely or show abrupt worsening in specific settings and thus further complicate the diagnostic workup. Awareness of the clinical and magnetic resonance imaging characteristics of different myelopathies and the specific settings where they occur is fundamental for a correct diagnosis. Neuroimaging helps distinguish compressive etiologies that may require urgent surgery from intrinsic etiologies that generally require medical treatment. Differentiation between various myelopathies is essential to establish timely and appropriate treatment and avoid harm from unnecessary procedures. This article reviews the contemporary spectrum of acute myelopathy etiologies and provides guidance for diagnosis and management.

Keywords

spinal cord - myelitis - differential diagnosis - misdiagnosis - treatment


Publication History

Article published online:
07 October 2021

© 2021. Thieme. All rights reserved.

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