Transverse Myelitis And Sacd

Question 1

Def of tm?

Answer 1

Acute or subacute inflammation of spinal cord after infection or recent vaccination

Question 2

Infectious agent of TM?

Answer 2

Measles, mumps varicella ebm cmv mycoplasma

Question 3

Differentiating point between TM and multiple sclerosis?

Answer 3

Sharp sensory level in transverse myelitis

Question 4

Features of TM?

Answer 4

Paraplegia, fever, pain in back and limbs, bladder disturbance
Sensory loss

Question 5

Investigation and treatment

Answer 5

MRI show swelling and distinguish from spinal cord compression
Glucocorticoids iv then oral
Patient may develop ms later

Question 6

Why sacd occur?

Answer 6

Due to vitamin B12 deficiency sequele and affect spinal cord ane peripheral nerve damage due to pernicious anemia or malnutrition

Question 7

At which segment changes occur?

Answer 7

Posterior column convery position sense and vibration and then lateral column
Peripheral nerves

Question 8

Clinical signs?

Answer 8

Paresthesias
Sensory loss first in lower limb then upper
Gloves and stoking manner loss of sensation
Tenderness of calf muscles
Positive rombergs
Ataxia
Initially loss of reflexes then exaggerated
Urinary retention
Mental impairment

Question 9

Diagnose

Answer 9

Blood cp show macrocytic anemia
Bone marrow megaloblastic bone marrow
Serum vit b12 less than 100pg/ml
Anti intrinsic antibody
Schilling test

Question 10

Treatment

Answer 10

Vit b12 1000g im daily fir 7 days then weekly for month then monthly for whole life