Differential Diagnosis of Longitudinally Extensive Transverse Myelitis in Adults

Review Article


Christopher Eckstein, Stephanie Syc and Shiv Saidha

Affiliation: Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA

ABSTRACT

Longitudinally extensive transverse myelitis (LETM), characterized by spinal cord inflammation extending three or more vertebral segments in length, may be caused by a multitude of disorders. LETM is most commonly associated with neuromyelitis optica (NMO). Such is the frequent association between these two entities that there is a growing tendency amongst physicians to regard them as being practically synonymous with each other. The objective of this review is to highlight the wide range of disorders that may cause LETM and to emphasize the need to carefully consider all potential etiologies in the assessment of LETM. In particular, we focus on the salient clinical, laboratory, and radiographic features of these various disorders, which help them to be differentiated from one another.

Keywords: Longitudinally Extensive Transverse Myelitis, LETM, NMO, neuromyelitis optica, myelopathy

Correspondence: Dr Shiv Saidha, Department of Neurology, Johns Hopkins University School of Medicine, Pathology 627, 600 North Wolfe Street, Baltimore, MD 21287, USA. Tel: +1-4106141653; Fax: +1-4105026736; e-mail: ssaidha2@jhmi.edu