Protocolo diagnóstico de las mielitis y otras mielopatías

Abstract

The initial strategy to clarify the etiology of a myelopathy is based on a combination of semiology, temporal pattern of onset and magnetic resonance findings. We may divide myelopathies into hyperacute (onset within hours, usually with a traumatic or vascular cause), acute-subacute (onset between one day and three weeks, including neoplastic, immune and infectious causes) and chronic (progression of the symptoms beyond 3 weeks, with metabolic, hereditary degenerative or structural causes such as dural fistulas and spondylosis, among others, although progressive forms of multiple sclerosis may present this temporary pattern). Spinal cord lesions in multiple sclerosis are usually short and peripheral, while in neuromyelitis optica they extend more than three vertebral segments, whereas involvement of the conus medullaris is typical in IgG-MOG disease.