Rinsho Shinkeigaku (Clinical Neurology)

Invited Review

The differential diagnosis of inflammatory and non-inflammatory myelopathy

Tetsuo Ando, M.D., Ph.D.1j

1)Department of Neurology, Kameda Medical Center

The differential diagnosis of inflammatory and non-inflammatory myelopathy can be challenging. Clinical information such as age, gender, speed of onset and progression, systemic symptoms, spinal cord and brain MRI, autoantibodies, and cerebrospinal fluid findings are necessary. The speed of onset is particularly important for differentiation. Inflammatory myelopathy typically follows an acute/subacute course, while spinal cord infarction presents with a hyperacute course, and intramedullary tumors often have a chronic progressive course. Spinal dural arteriovenous fistula usually shows a chronic progressive course, but it can present with fluctuating symptoms in the early stages and may appear as an acute onset. It is essential to definitively exclude compressive myelopathy for the diagnosis of inflammatory myelopathy. Even if a definitive diagnosis cannot be made, regular reevaluation during treatment is necessary.
Full Text of this Article in Japanese PDF (2333K)

(CLINICA NEUROL, 63: 806|812, 2023)
key words: multiple sclerosis (MS), neuromyelitis optica (NMO), inflammatory myelopathy, spinal cord infarction, spinal dural arteriovenous fistula

(Received: 23-Jul-23)