Service de neurologie, sclérose en plaques, pathologies de la myéline et neuro-inflammation, centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM), hôpital neurologique Pierre-Wertheimer, 59, boulevard Pinel, 69677 Bron cedex, France.
Rev Neurol (Paris). 2021 May;177(5):557-566. doi: 10.1016/j.neurol.2020.08.003. Epub 2020 Oct 21.
Myelopathy is a term referring to any pathologic process affecting the spinal cord, and encompasses a broad spectrum of etiologies. The first step is to categorize myelopathy, according to the time to reach maximum deficit. Myelopathies are commonly classified as acute, subacute or chronic, for which the etiologies are totally different. Myelopathy is considered acute when the symptoms progress to their nadir in maximum 21 days after onset. Due to heterogeneity in pathogenesis, and the overlap in the clinical and imaging presentation among etiologies, acute myelopathy is considered as a diagnostic dilemma. A simple and efficient algorithm for timely identification of the underlying cause is thus useful. In this review, we provide a simplified approach for the differential diagnosis among all causes of acute myelopathies, and describe the principal clinical and imaging features of the main etiologies in adults, including recently characterized antibody-mediated myelitis, and its mimics.
脊髓病是指任何影响脊髓的病理过程的术语，包括广泛的病因。第一步是根据达到最大缺陷的时间对脊髓病进行分类。脊髓病通常分为急性、亚急性或慢性，其病因完全不同。当症状在发病后 21 天内发展到最低点时，脊髓病被认为是急性的。由于发病机制的异质性，以及病因之间的临床表现和影像学表现的重叠，急性脊髓病被认为是一个诊断难题。因此，及时确定潜在病因的简单有效的算法是有用的。在这篇综述中，我们提供了一种简化的方法来鉴别急性脊髓病的所有病因，并描述了成人中主要病因的主要临床和影像学特征，包括最近描述的抗体介导的脊髓炎及其类似物。
