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Dr. Andrew Rynne

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What is the cure for acute transverse myelitis?

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Dr. Shiva Kumar R

Neurologist

Practicing since :2001

Answered : 504 Questions

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Posted on Sat, 21 Apr 2012 in Brain and Spine
Question: mri cervical spine
following impression found:
Diffuse Hyperintensity involving the entire cord from c2 to d12 with mild cord expansion - acute transverse myelitis
can you through lite what will be the cure nature of action to be taken and which specialist needs to be consulted. XXXXXXX sheker Hyderabad AP India.
doctor
Answered by Dr. Shiva Kumar R 42 minutes later
Hi XXXXXXX Sheker,

Thanks for the query.

It would be good if you could have detailed about the problem, duration of the problem. It is important to know the reason why the MRI is ordered in first place by the primary doctor, I mean their first impression.

The MRI report has no good significance when there is no description about the problem and its nature.

MRI findings is suggestive demyelination of the spinal cord extending from C2-D12 level. We call this as long segment extensive myelitis. This has to be immediately treated by Neurologist. She has to undergo certain tests to find out why this has happened. If treated early and properly he/she has good chances of near complete recovery. So get her treated from a good Neurologist as early as possible.

Hope it answers and I expect a detailed history now.

Regards,



Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Shiva Kumar R 2 hours later
1.actions led to MRI are:
(i)breathlessness followed by unable to walk and pain in waist for last 1 week.
i.e., from 15-07-11.
2.findings of mri's on 2 different dates:
(i)date:28-09-10
report:mri brain with and without 4 contrast
IMPRESSION OR RESULTmild diffuse enlargement,suitable hyperintensity,enhancement of retrobular portion of left optic nerve-- due to inflammation.
(ii).date:17-7-11
report:MRI BRAIN PLANE STUDY
IMPRESSION:small speck of t2/flair hyperintensity noted int he splenium of corpus callosum
-?cause/significance
SUGGESTED CLINICAL CORRELATION AND FOLLOW-UP
3. details of findings of earlier episode to the eye before the present problem furnished below:
Date:october28,2010
MEDICAL REPORT:
mrs.konduri XXXXXXX a 38 year old lady presented to us on 28-9-2010 with chief complintes of sudden painless loss of vision in the left eye since 3 days.There was no other significant ocular or systemic complaints.
on examination her visual acuity was a 6/9 in the right eye and CF @two and half meters in the left eye. intraocular pressure was 12mm of Hg in both eyes. Ocular movements were full.Anterior segment was normal in both eyes.There was RAPD in the left eye.Dilated fundus examination was normal in both eyes.optic disc showed CD ratio of 0.1:1 in both eyes.

based on the above clinical findings a diagnosis of a retrobulbar neuritis in the left eye was maid.VEP showed redused amplitude with delayed latency in the right eye and a extinguished wave with 120 checker size in left eye. MRI brain which showed enhancement of retrobular portion of left optic nerve.an impression of left eye retrobulbar neuritis was maid. she was explained abt the condition and inj IVMP 250mg 4 times a day after physican openion.she was admited on the same day and started inj IVMP 4 times a day for three days. after completing all the does he was discharged on 4-10-2010.she was doing well.she was advised to use tab Wysolone50 mg 1ce a day,tab shelcal 500mg 1ce a day and tab rantac 150mg 2 times a day.she was asked to cme for review after 2 months.
XXXXXXX sheker XXXXXXX
doctor
Answered by Dr. Shiva Kumar R 6 hours later
Hi,

Thanks for replying back to us.

The information you provided suggests that she had demyelination of the optic nerve and now of the spinal cord. Possibility of multiple sclerosis is unlikely because long segment spinal cord involvement is not a feature of MS. The etiology or cause is likely to be vasculitis, infective causes or may be a case of Neuromyelitis optica. A detailed evaluation is required for the cause of demyelination like CSF study, oligoclonal bands, sarcoid, CNS vasculitis, Herpes myelitis and so on. Get her evaluated and treat accordingly.

Hope I have answered your query. If you have any follow up queries I will be available to answer them.

Wish You Good Health.
Above answer was peer-reviewed by : Dr. Raju A.T
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