Abstract
Objectives
Transverse myelitis (TM) is a rare inflammatory disorder of the spinal cord with diverse
etiologies, often leading to significant neurological deficits. Accurate and timely diagnosis is
essential but challenging due to the overlap of clinical presentations and imaging findings.
Materials and Methods
A retrospective case series of six patients hospitalized at a university center was analyzed.
Clinical presentations, cerebrospinal fluid (CSF) findings, and multimodal imaging results,
including MRI and PET/CT, were reviewed to identify diagnostic challenges and therapeutic
responses.
Results
Case 1: A 52-year-old female with diplopia and gait disturbances was diagnosed with tick-borne
encephalitis-related myelitis based on CSF and MRI findings.
Case 2: A 59-year-old female with a history of spinal meningioma developed radiation-induced
myelitis at the Th11 level, confirmed by MRI demonstrating focal spinal cord edema.
Case 3: A 27-year-old female with cervical and thoracic spinal cord lesions underwent PET/CT,
revealing mediastinal lymphadenopathy consistent with neurosarcoidosis; spinal MRI
demonstrated positive dynamic.
Case 4: A 32-year-old female with acute lower limb paresthesia and paresis showed thoracic
myelitis on MRI (Th4–Th6) and CSF oligoclonal bands, suggesting a demyelinating pathology.
Case 5: A 52-year-old female comorbid with HCV infection presented with acute tetraparesis;
cervical MRI revealed longitudinal lesions at C5–C7, with CSF showing elevated IgG. Steroid
therapy and plasma exchange resulted in clinical improvement.
Case 6: A 49-year-old male comorbid with HIV infection with urinary retention and lumbar pain
exhibited longitudinal extensive thoracic myelitis (Th2–Th10) on MRI. Symptoms were
retrospectively associated with previous HCV therapy; corticosteroid treatment led to partial
neurological recovery.
Conclusions
Transverse myelitis represents a heterogeneous group of disorders requiring careful clinical
evaluation and advanced imaging techniques for accurate diagnosis. This case series emphasizes
the pivotal role of MRI and adjunctive modalities such as PET/CT in differentiating underlying
etiologies and optimizing treatment strategies to improve patient outcomes
Transverse myelitis (TM) is a rare inflammatory disorder of the spinal cord with diverse
etiologies, often leading to significant neurological deficits. Accurate and timely diagnosis is
essential but challenging due to the overlap of clinical presentations and imaging findings.
Materials and Methods
A retrospective case series of six patients hospitalized at a university center was analyzed.
Clinical presentations, cerebrospinal fluid (CSF) findings, and multimodal imaging results,
including MRI and PET/CT, were reviewed to identify diagnostic challenges and therapeutic
responses.
Results
Case 1: A 52-year-old female with diplopia and gait disturbances was diagnosed with tick-borne
encephalitis-related myelitis based on CSF and MRI findings.
Case 2: A 59-year-old female with a history of spinal meningioma developed radiation-induced
myelitis at the Th11 level, confirmed by MRI demonstrating focal spinal cord edema.
Case 3: A 27-year-old female with cervical and thoracic spinal cord lesions underwent PET/CT,
revealing mediastinal lymphadenopathy consistent with neurosarcoidosis; spinal MRI
demonstrated positive dynamic.
Case 4: A 32-year-old female with acute lower limb paresthesia and paresis showed thoracic
myelitis on MRI (Th4–Th6) and CSF oligoclonal bands, suggesting a demyelinating pathology.
Case 5: A 52-year-old female comorbid with HCV infection presented with acute tetraparesis;
cervical MRI revealed longitudinal lesions at C5–C7, with CSF showing elevated IgG. Steroid
therapy and plasma exchange resulted in clinical improvement.
Case 6: A 49-year-old male comorbid with HIV infection with urinary retention and lumbar pain
exhibited longitudinal extensive thoracic myelitis (Th2–Th10) on MRI. Symptoms were
retrospectively associated with previous HCV therapy; corticosteroid treatment led to partial
neurological recovery.
Conclusions
Transverse myelitis represents a heterogeneous group of disorders requiring careful clinical
evaluation and advanced imaging techniques for accurate diagnosis. This case series emphasizes
the pivotal role of MRI and adjunctive modalities such as PET/CT in differentiating underlying
etiologies and optimizing treatment strategies to improve patient outcomes
| Original language | English |
|---|---|
| Pages | 15 |
| Number of pages | 15 |
| Publication status | Published - 7 Nov 2025 |
| Event | The 11th Baltic Congress of Neurology - Riga , Latvia Duration: 6 Nov 2025 → 8 Nov 2025 |
Congress
| Congress | The 11th Baltic Congress of Neurology |
|---|---|
| Country/Territory | Latvia |
| City | Riga |
| Period | 6/11/25 → 8/11/25 |
Field of Science*
- 3.2 Clinical medicine
Publication Type*
- 3.4. Other publications in conference proceedings (including local)
