Differentials
Non-compressive myelopathy
SIGNS / SYMPTOMS
Similar neurological picture. No history of trauma or other acute event.
Examples include multiple sclerosis, neuromyelitis optica spectrum disorder, idiopathic transverse myelitis, Guillain-Barré syndrome, motor neuron disease.
INVESTIGATIONS
MRI for evidence of cord parenchymal disruption and pattern suggestive of an aetiology. Electrodiagnostic studies additionally for Guillain-Barré syndrome and motor neuron disease.
Compressive myelopathy
SIGNS / SYMPTOMS
Similar neurological picture. No history of trauma or other acute event. May be signs/symptoms of infection or malignancy.
Examples include vertebral compression fractures, intervertebral disc disease, malignancy, infection (spinal epidural abscess), vascular malformation or haematoma.
INVESTIGATIONS
MRI demonstrates parenchymal lesion and source of spinal cord compression. CT scans better evaluate boney architecture.
FBC, CRP, and erythrocyte sedimentation rate usually elevated in infection.
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