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磁共振成像在横断性脊髓炎诊断中的关键作用:病例报告。

The critical role of magnetic resonance imaging in the diagnosis of transverse myelitis: a case report.

机构信息

Department of Medicine and Surgery, Ladoke Akintola University of Technology, Ogbomoso, Nigeria.

Orthopaedics Unit, Department of Surgery, Ladoke Akintola University Teaching Hospital, Ogbomoso, Nigeria.

出版信息

Spinal Cord Ser Cases. 2024 Feb 10;10(1):4. doi: 10.1038/s41394-024-00616-7.

Abstract

INTRODUCTION

Transverse Myelitis is a rare inflammatory disorder of the spinal cord, characterized by the inflammation of the myelin sheath covering nerve fibers. Although rare, Transverse Myelitis holds significant clinical importance due to its potential life-altering consequences. The case report provides insight into the clinical presentation of Transverse Myelitis and the importance of Magnetic Resonance Imaging in confirming Transverse Myelitis.

CASE PRESENTATION

A 27-year-old Nigerian female presented to a hospital facility after 2 months onset of paraplegia, urinary, and fecal incontinence. She was diagnosed with Acute Transverse Myelitis with Magnetic Resonance Imaging, a lacking imaging modality in Nigeria. On presentation, it was important to rule out spinal cord compression, a close differential to her presentation. Despite her late arrival at the facility, early diagnosis and prompt initiation of treatment with high-dose intravenous steroids and physiotherapy improved her quality of life.

DISCUSSION

This case report reveals the poor health-seeking behavior in developing countries and the need for imaging modalities like Magnetic Resonance Imaging for improved diagnoses of rare neurological conditions such as Transverse Myelitis. The lack of healthcare infrastructure has led to clinical misdiagnosis, patient mismanagement, and underrepresentation of data in the country, underscoring the critical role of diagnostic tools for improved patient care pre-treatment and post-treatment. Additionally, follow-up of these patients is important to prevent the long-term sequelae of Transverse Myelitis like Neuromyelitis Optica or Multiple Sclerosis.

摘要

简介

横贯性脊髓炎是一种罕见的脊髓炎症性疾病,其特征是覆盖神经纤维的髓鞘发生炎症。尽管横贯性脊髓炎较为罕见,但由于其可能改变生活的后果,因此具有重要的临床意义。本病例报告深入了解了横贯性脊髓炎的临床表现,以及磁共振成像在确诊横贯性脊髓炎方面的重要性。

病例介绍

一位 27 岁的尼日利亚女性在出现截瘫、尿失禁和大便失禁 2 个月后到医院就诊。她被诊断为急性横贯性脊髓炎,磁共振成像(MRI)是尼日利亚缺乏的一种影像学检查方法。在就诊时,排除脊髓压迫症很重要,这是与她的表现密切相关的鉴别诊断。尽管她很晚才到医院就诊,但早期诊断和及时开始用大剂量静脉内类固醇和物理疗法治疗,改善了她的生活质量。

讨论

本病例报告揭示了发展中国家寻求医疗服务的不良行为,以及需要像 MRI 这样的影像学检查方法,以改善对罕见神经疾病(如横贯性脊髓炎)的诊断。缺乏医疗保健基础设施导致了临床误诊、患者管理不善,以及国家数据代表性不足,突显了诊断工具在治疗前和治疗后改善患者护理的关键作用。此外,对这些患者进行随访对于预防横贯性脊髓炎的长期后遗症(如视神经脊髓炎或多发性硬化症)非常重要。

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