Acute transverse myelitis after DTP vaccine.
T2-weighted MRI showing diffuse cord edema, signal hyperintensity (C3-T6).
From PMID: 16317420.

Thanks to Dr. Nguyen-Fa for a great presentation on transverse myelitis!

Learning points:

• Ddx for upper + lower motor neuron symptoms includes ALS, MS, transverse myelitis, ADEM, compressive myeloradiculopathy, HIV, B12 deficiency, WNV
• Proposed diagnostic criteria of acute transverse myelitis (PMID: 12236201):
  • Sensory/motor/autonomic dyusfunction attributable to spinal cord
  • Bilateral s/s
  • Clearly defined sensory level
  • No compressive cord lesion
  • CSF pelocytosis OR elevated IgG index OR gadolinium enhancement
  • Progression to nadir between 4h – 21 d.
• Treated with steroids +/- plasmapharesis +/- cyclophosphamide