PowerPoint Presentation - The Transverse Myelitis Association

Differential Diagnosis of Transverse Myelitis
Maureen A. Mealy, RN, BSN, Daniel Becker MD, Scott D. Newsome, DO,
John N. Ratchford, MD, Michael Levy, MD, PhD, Carlos A. Pardo, MD
The Johns Hopkins Transverse Myelitis
Center performed a retrospective
analysis to determine the true spectrum
of diagnoses of those patients referred
to and seen for the presumed diagnosis
of TM at the time of referral.
As you know, TM is a non-specific
inflammatory attack of the spinal cord.
The common causes include
monophasic idiopathic transverse
myelitis (ITM), multiple sclerosis (MS),
neuromyelitis optica (NMO) and
rheumatologic diseases. The JHTMC is
dedicated to the diagnosis and
management of TM, and to other
conditions that can mimic TM.
We reviewed 591 patients who
presented between August 2010 and
July 2013. The final diagnoses were
based on clinical profiles, neuroimaging,
and the specific diagnostic criteria for
each disease or condition for which
patients were eventually diagnosed
after extensive work-ups were
completed. The goal was to report the
full differential diagnosis of TM,
including non-inflammatory causes.
This research was made possible because of the generosity and support of Johns Hopkins Project
RESTORE, the Bart McLean Fund for Neuroimmunology Research, and most especially the patients of
the Johns Hopkins Transverse Myelitis Center.
Two-thirds of patients
referred to the JHTMC had
inflammatory TM. However
26% of patients initially
diagnosed with TM did not
have inflammatory myelitis,
5% of whom did not have
myelopathy at all. The
findings suggest that a
portion of patients
diagnosed with TM may
have other non-inflammatory
causes of myelopathies that
deserve a more detailed

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