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Rev Neurol. 2015 Dec 1;61(11):499-502.

Spondylotic myelopathy mimicking myelitis: diagnostic clues by magnetic resonance imaging.

[Article in English, Spanish; Abstract available in Spanish from the publisher]

Author information

1
Hospital Clinic de Barcelona. Institut Clinic de Malalties del Sistema Nervios, 08036 Barcelona, Espana.

Abstract

in English, Spanish

INTRODUCTION:

Spondylotic myelopathy is the commonest cause of nontraumatic myelopathy. Radiological features of spondylotic myelopathy can often overlap with inflammatory myelopathies which may lead to a delayed or incorrect diagnosis and therapy. A distinctive gadolinium enhancement pattern recently described may help to differentiate spondylotic from inflammatory myelopathy.

CASE REPORTS:

Case 1: a 38-years-old man presented with a 2-year history of paresthesias in the upper extremities, and one year later cramps on the right limbs and numbness over right C5 and C6 dermatomes, related to movement of the neck. Case 2: a 44-year-old man presented with a 1-year history of progressive gait difficulties and sensory disturbance in the hands, and a recent onset of bladder dysfunction. In both cases, spinal cord MRI identified a longitudinal cervical T2-signal hyperintensity associated with a pancakelike transverse band of gadolinium enhancement just below the site of maximum spinal stenosis, and circumferential or hemicord enhancement on axial images.

CONCLUSIONS:

The radiological features of spondylotic myelopathy may resemble those of inflammatory origin. The recognition of a transverse pancakelike gadolinium enhancement immediately below the site of maximal compression as a typical radiological pattern of spondylotic myelopathy is important to reduce the risk of misdiagnosis and to help in the management of these patients.

PMID:
26602804
[Indexed for MEDLINE]
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