LOCATION
|
SAGITTAL T2 |
POST CONTRAST SAGITTAL |
Other features |
|
Cervical/ Thoracic: Single long segment 1
MRI may be normal in a third of patients2.
|
Longitudinally extensive, symmetric, tract-specific
signal changes within the spinal cord.
|
Tract-Specific enhancement (usually lateral columns)
Dorsal column or central gray involvement also reported2.
Differential: Vitamin B12 and copper deficiency, although these
do not enhance.
Enhancement may be minimal3.
If linear enhancement involves anterior horn cells on axial,
supports anterior spinal artery infarct4.
|
MRI normal in up to 50%.
May have insidious, progressive course resembling
primary progressive MS; may have acute or
relapsing presentations5.
Common neural autoantibodies found:
Most common neoplasms:
Breast and lung cancer
|
|
|
From: Ref 1
From: Ref 2
|
From: Ref 1
From: Ref 2
|
|
|
|
|
AXIAL T2 |
POST CONTRAST |
|
| |
|
Tract-specific signal (dorsal/ lateral column)
Changes may be dorsal or lateral column, or central gray3.
From: Ref 1
|
From: Ref 1
|
|
| |
|
From: Ref 2
|
From: Ref 2
|
|
References
1 Lopez Chiriboga S, Flanagan EP. Myelitis and Other Autoimmune Myelopathies. Contin Lifelong Learn Neurol 2021; 27: 62–92.
2 Flanagan EP, McKeon A, Lennon VA, et al. Paraneoplastic isolated myelopathy: Clinical course and neuroimaging clues. Neurology 2011; 76: 2089–95.
3 Liu Z, Jiao L, Qiu Z, et al. Clinical characteristics of patients with paraneoplastic myelopathy. J Neuroimmunol 2019; 330: 136–42.
4 Mustafa R, Passe TJ, Lopez-Chiriboga AS, et al. Utility of MRI Enhancement Pattern in Myelopathies With Longitudinally Extensive T2 Lesions. Neurol Clin Pract 2021; 11: E601–11.
5 Flanagan EP, Keegan BM. Paraneoplastic Myelopathy. Neurol Clin 2013; 31: 307–18.
