Acute myelopathy of unknown aetiology: A follow-up investigation

Acute myelopathy refers to acute or subacute spinal cord dysfunction secondary to various causes. Recent studies suggest a number of distinct clinical, laboratory, MRI and outcome profiles for the various aetiologies. Nevertheless, the aetiology of acute myelopathy remains unknown in up to 60% of th...

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Bibliographic Details
Published in:Journal of clinical neuroscience 2006-04, Vol.13 (3), p.339-342
Main Authors: Nowak, Dennis A., Mutzenbach, Sebastian, Topka, Helge
Format: Article
Language:English
Subjects:
Acute myelopathy
Adult
Aetiology
Aged
Electrophysiology - methods
Female
Follow-up
Follow-Up Studies
Humans
Magnetic Resonance Imaging - methods
Male
Middle Aged
Multiple Sclerosis - complications
Prognosis
Retrospective Studies
Spinal Cord Diseases - etiology
Spinal Cord Diseases - pathology
Spinal Cord Diseases - physiopathology
Vascular Diseases - complications
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Summary:Acute myelopathy refers to acute or subacute spinal cord dysfunction secondary to various causes. Recent studies suggest a number of distinct clinical, laboratory, MRI and outcome profiles for the various aetiologies. Nevertheless, the aetiology of acute myelopathy remains unknown in up to 60% of the patients. The probability of establishing the correct diagnosis increases with the duration of clinical and MRI follow-up. This paper presents the results of a follow-up of nine cases of acute myelopathy of unknown aetiology. One patient was lost during follow-up. Mean age of patients at the time of the follow-up interview was 48 years (±12). Average time from discharge to follow-up interview was 3.6 (±0.5) years. In four patients (mean age 45 ± 13 years) the origin of acute myelopathy remained unclear after an average follow-up of 3.3 years. In one patient the diagnosis of multiple sclerosis was established during follow-up. In another patient the clinical course was suggestive for multiple sclerosis. One patient was diagnosed with systemic collagen vascular disease and in one patient a diagnosis of non-Hodgkin’s lymphoma was established. It is unclear whether the patients in whom the aetiology of acute myelopathy remained unknown, even after several years of follow-up, are at a higher risk of developing progressive disease. Larger studies with longer follow-up periods and clear clinical, laboratory and MRI criteria should help to shed some light on this issue.
ISSN:0967-5868
1532-2653
DOI:10.1016/j.jocn.2005.03.034