Age | Course | Clinical features | Diagnosis | |
Cervical spondylotic myelopathy | Usually >60 years | Progressive or stepwise course | Moderate-severe cases demonstrate gait and leg spasticity and amyotrophy of hand or arms | MRI cervical spine |
Transverse myelitis (including multiple sclerosis and other causes) | Children, young adults | Subacute | Segmental cord syndrome | MRI and CSF |
Viral myelitis | Any age | Acute-subacute | Pure motor syndrome or segmental cord syndrome | MRI and CSF |
Epidural abscess | Any age | Subacute; may worsen abruptly | Segmental cord syndrome | MRI |
Infarction | Usually >60 years | Abrupt onset | Anterior cord syndrome | MRI with diffusion-weighted sequences |
Vascular malformation | >40 years (dural fistula) 20s (intramedullary AVM) | Acute and/or stepwise | Radiculomyelopathy | MRI, spinal angiography |
Subacute combined degeneration | Any age | Slowly progressive | Dorsal cord syndrome | Vitamin B12 levels |
Radiation | Any age | Slowly progressive; beginning 6 to 12 months after radiation therapy | Segmental cord syndrome or ventral cord syndrome | MRI, clinical history |
Syringomyelia | Children, young adults | Slowly progressive | Central cord syndrome | MRI |
Epidural metastasis | Usually >50 years | Subacute; may worsen abruptly | Segmental cord syndrome | MRI |
Intramedullary tumor | Young adults | Slowly progressive | Central cord syndrome | MRI with gadolinium enhancement |
ALS | Usually >60 years | Progressive | Pure motor syndrome | Electromyography |
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