Introduction

Transverse myelitis (TM) is an inflammatory disorder of the spinal cord characterized by rapid onset of neurologic symptoms.

Pathophysiology

TM is an immune-mediated disorder characterized by infiltration of inflammatory cells into a segment of the spinal cord.  This leads to neuron and oligodendrocyte cell death and demyelination, which causes neurologic impairment in a characteristic pattern.

Epidemiology and risk factors

Most cases of TM follow a recent infection (eg, gastroenteritis, upper respiratory infection).  The condition is also associated with various autoimmune disorders, including multiple sclerosis, neuromyelitis optica, and systemic diseases (eg, systemic lupus erythematosus).  TM has a bimodal peak, with most cases occurring in the teens and 30s.

Clinical presentation

Patients with TM typically have acute-onset, rapidly progressive myelopathy that localizes to ≥1 contiguous spinal cord segments

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