The critical role of magnetic resonance imaging in the diagnosis of transverse myelitis: a case report.

IF 0.7 Q4 CLINICAL NEUROLOGY Spinal Cord Series and Cases Pub Date : 2024-02-10 DOI:10.1038/s41394-024-00616-7
Esther Omotola Adewuyi, Zainab Adedamola Abdulsalam, Olorunnisola Onaolapo Olatide
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Abstract

Introduction: Transverse Myelitis is a rare inflammatory disorder of the spinal cord, characterized by the inflammation of the myelin sheath covering nerve fibers. Although rare, Transverse Myelitis holds significant clinical importance due to its potential life-altering consequences. The case report provides insight into the clinical presentation of Transverse Myelitis and the importance of Magnetic Resonance Imaging in confirming Transverse Myelitis.

Case presentation: A 27-year-old Nigerian female presented to a hospital facility after 2 months onset of paraplegia, urinary, and fecal incontinence. She was diagnosed with Acute Transverse Myelitis with Magnetic Resonance Imaging, a lacking imaging modality in Nigeria. On presentation, it was important to rule out spinal cord compression, a close differential to her presentation. Despite her late arrival at the facility, early diagnosis and prompt initiation of treatment with high-dose intravenous steroids and physiotherapy improved her quality of life.

Discussion: This case report reveals the poor health-seeking behavior in developing countries and the need for imaging modalities like Magnetic Resonance Imaging for improved diagnoses of rare neurological conditions such as Transverse Myelitis. The lack of healthcare infrastructure has led to clinical misdiagnosis, patient mismanagement, and underrepresentation of data in the country, underscoring the critical role of diagnostic tools for improved patient care pre-treatment and post-treatment. Additionally, follow-up of these patients is important to prevent the long-term sequelae of Transverse Myelitis like Neuromyelitis Optica or Multiple Sclerosis.

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磁共振成像在横贯性脊髓炎诊断中的关键作用:病例报告。
简介横贯脊髓炎是一种罕见的脊髓炎症性疾病,其特征是覆盖神经纤维的髓鞘发炎。横贯性脊髓炎虽然罕见,但由于其潜在的改变生命的后果而具有重要的临床意义。本病例报告介绍了横贯性脊髓炎的临床表现以及磁共振成像在确诊横贯性脊髓炎方面的重要性:一名 27 岁的尼日利亚女性因截瘫、大小便失禁 2 个月后到医院就诊。她通过磁共振成像被诊断为急性横贯性脊髓炎,这是尼日利亚缺乏的一种成像方式。就诊时,必须排除脊髓压迫的可能性,这与她的症状有密切的区别。尽管她到达医疗机构的时间较晚,但早期诊断和及时启动大剂量静脉类固醇及物理治疗改善了她的生活质量:本病例报告揭示了发展中国家患者就医行为的不规范,以及磁共振成像等成像模式对改善横贯性脊髓炎等罕见神经系统疾病诊断的必要性。医疗保健基础设施的缺乏导致了临床误诊、患者管理不善以及国内数据代表性不足,这突出了诊断工具在改善患者治疗前和治疗后护理方面的关键作用。此外,对这些患者进行随访对于预防横贯性脊髓炎的长期后遗症(如神经脊髓炎或多发性硬化症)也非常重要。
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来源期刊
Spinal Cord Series and Cases
Spinal Cord Series and Cases Medicine-Neurology (clinical)
CiteScore
2.20
自引率
8.30%
发文量
92
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