Clinical Differentiators of Spinal Cord Diseases

Clinicians at a specialized transverse myelitis referral center reviewed the final diagnosis and clinical features for 457 patients referred for further evaluation and management. Only 54% were confirmed to be inflammatory (e.g., multiple sclerosis, neuromyelitis optica, rheumatologic); the remainder were 20% vascular (e.g., ischemia, arteriovenous malformation/fistula [AVM]), 8% spondylotic (degenerative, arthritic, compressive), and 18% other.

No single clinical, cerebrospinal fluid (CSF), or imaging characteristic differentiated the underlying causes with absolute certainty. Characteristics associated with inflammatory myelitis (IM) included younger age at onset, subacute presentation (48 hours to 21 days), and history of an autoimmune di…