MULTIPLE-SCLEROSIS PRESENTING AS TRANSVERSE MYELOPATHY - CLINICAL ANDMRI FEATURES

We described specific MRI features of MS presenting with acute partial transverse myelopathy. We reviewed the clinical histories and MRI stu dies of brain and spinal cord of 24 patients, using axial and sagittal images of the spinal cord to define patterns of signal abnormality in the context of clinical presentation, course, and vertebral column st ructural pathology. The heterogeneity of spinal cord tract involvement was greater than previously reported, with signal abnormality identif ied within the central cord, crossing the gray-white junction, and inv olving all four major funiculi. Correlation between spinal cord MRI fi ndings and neurologic deficits was strong (100% by axial images; 96% b y sagittal images). Serial spinal cord MRI demonstrated the dynamic na ture of the signal abnormalities over time and in response to high-dos e steroid treatment. No cranial MRI abnormality initially was seen in 36% of cases with evidence of demyelinating disease on concurrent spin al MRI.