好色先生

好色先生

Explore the latest content from across our publications
Join The AAN

Log In

Forgot Password?
Create New Account

Loading... please wait

Abstract Details

Clinical and Magnetic Resonance Imaging Features of Idiopathic Myelitis
Autoimmune Neurology
P8 - Poster Session 8 (8:00 AM-9:00 AM)
8-020

To describe clinical and magnetic resonance imaging (MRI) features of idiopathic myelitis.
Despite progress in identifying the etiological diagnoses of myelitis, the cause of inflammatory myelopathies remains unknown in some persons.

Retrospective chart review was performed for individuals referred to a specialized myelopathy center with “idiopathic myelitis” between 2006-2023. We propose a definition of idiopathic myelitis as: 1) sensory, motor, or autonomic dysfunction attributable to the spinal cord, 2) MRI lesion gadolinium enhancement or cerebrospinal fluid white cell count >5/uL, 3) absence of MRI evidence of compressive or vascular myelopathies, 4) exclusion of multiple sclerosis, 5) negative serum aquaporin-4 and myelin oligodendrocyte glycoprotein antibodies, and 6) absence of rheumatological disorder and infection/vaccination within 4 weeks of onset. Diagnosis, time to symptom nadir, and brain and spinal cord MRI features were evaluated.
Of 140 individuals diagnosed with idiopathic myelitis, 24 met our proposed definition. Thirteen (54%) were male and 15 (62%) were white with a median age of 52.5 years (range, 23-74 years). Temporal profile was subacute (48 hours to 21 days) in 14 (58%) individuals and chronic (>21 days) in 6 (25%). MRI of 22 individuals showed spinal cord signal abnormalities. Of these, 15 (68%) were short segment lesions (<3 vertebral bodies in length), 15 were monofocal, and all showed gadolinium enhancement. In 20 individuals with available MRIs, 19 (95%) lesions involved the central spinal cord with 5 exclusive to the central cord and others also affecting a combination of anterior, posterior, and lateral white matter tracts. No lesions were isolated to anterior white matter tracts.
In this cohort of individuals with idiopathic myelitis, subacute to chronic symptom evolution was frequent. Common MRI features included short segment, monofocal, gadolinium enhancing lesions involving the central cord. Updated diagnostic criteria are needed for further clinical and radiographic phenotyping of idiopathic myelitis.
Authors/Disclosures
Asli Buyukkurt, MD
PRESENTER 		Dr. Buyukkurt has nothing to disclose.
David Acero-Garces, MD Dr. Acero-Garces has nothing to disclose.
Paula Barreras, MD (Cedars-Sinai Medical Center) Dr. Barreras has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. The institution of Dr. Barreras has received research support from Foundation for Sarcoidosis Research. The institution of Dr. Barreras has received research support from 好色先生.
Olwen Murphy, MD (Johns Hopkins Hospital) Dr. Murphy has nothing to disclose.
Scott D. Newsome, DO, FAAN (Johns Hopkins Hospital) Dr. Newsome has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. Dr. Newsome has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Newsome has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for TG Therapeutics. The institution of Dr. Newsome has received research support from Biogen. The institution of Dr. Newsome has received research support from Genentech/Roche. The institution of Dr. Newsome has received research support from Department of Defense. The institution of Dr. Newsome has received research support from Patient Centered Outcomes Research Institute. The institution of Dr. Newsome has received research support from National MS Society. The institution of Dr. Newsome has received research support from Lundbeck. The institution of Dr. Newsome has received research support from Sanofi. The institution of Dr. Newsome has received research support from Kyverna Therapeutics. Dr. Newsome has received personal compensation in the range of $10,000-$49,999 for serving as a Lead PI for Clinical Trial with Roche.
Carlos A. Pardo-Villamizar, MD (Johns Hopkins U, Med Dept of Neurology) The institution of Dr. Pardo-Villamizar has received research support from National Institutes of Health. The institution of Dr. Pardo-Villamizar has received research support from Bart McLean Fund for Neuroimmunology Research .