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    Myelitis: Dr. Kiking Ritarwan, MKT, Sps

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    Annisa Sasa
    This document discusses transverse myelitis, an inflammation of the spinal cord. It can be caused by infections, autoimmune disorders, tumors, or unknown causes. The main symptoms are acute paralysis or weakness in the legs or arms. Diagnosis involves MRI of the spine and examination of cerebrospinal fluid. Treatment focuses on treating any underlying cause, using corticosteroids to reduce inflammation, and medications to manage symptoms like spasms. The prognosis depends on the severity and cause, with many cases resulting in permanent neurological deficits.

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    Myelitis: Dr. Kiking Ritarwan, MKT, Sps

    Uploaded by

    Annisa Sasa
    600 views15 pages
    This document discusses transverse myelitis, an inflammation of the spinal cord. It can be caused by infections, autoimmune disorders, tumors, or unknown causes. The main symptoms are acute paralysis or weakness in the legs or arms. Diagnosis involves MRI of the spine and examination of cerebrospinal fluid. Treatment focuses on treating any underlying cause, using corticosteroids to reduce inflammation, and medications to manage symptoms like spasms. The prognosis depends on the severity and cause, with many cases resulting in permanent neurological deficits.

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    This document discusses transverse myelitis, an inflammation of the spinal cord. It can be caused by infections, autoimmune disorders, tumors, or unknown causes. The main symptoms are acute paralysis or weakness in the legs or arms. Diagnosis involves MRI of the spine and examination of cerebrospinal fluid. Treatment focuses on treating any underlying cause, using corticosteroids to reduce inflammation, and medications to manage symptoms like spasms. The prognosis depends on the severity and cause, with many cases resulting in permanent neurological deficits.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    600 views15 pages

    Myelitis: Dr. Kiking Ritarwan, MKT, Sps

    Uploaded by

    Annisa Sasa
    This document discusses transverse myelitis, an inflammation of the spinal cord. It can be caused by infections, autoimmune disorders, tumors, or unknown causes. The main symptoms are acute paralysis or weakness in the legs or arms. Diagnosis involves MRI of the spine and examination of cerebrospinal fluid. Treatment focuses on treating any underlying cause, using corticosteroids to reduce inflammation, and medications to manage symptoms like spasms. The prognosis depends on the severity and cause, with many cases resulting in permanent neurological deficits.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 15

    Myelitis

    Dr. Kiking Ritarwan, MKT, SpS

    Myelitis
    Inflamation

    of the spinal cord


    I. Transverse Myelitis, II. Disseminata, III. Difussa
    Transverse myelitis (MYELOPATHY) is a syndrome
    characterized by acute spinal cord dysfunction both
    halves the cord in transverse section.

    Myelitis

    transversalis

    inflamasi akut atau sub akut


    mengenai suatu area fokal di medula spinalis
    karakteristik klinis disfungsi neurologis pada saraf
    motorik, sensorik dan otonom dan traktus saraf di
    medula spinalis

    MYELITIS
    Gray matter Poliomyelitis.
    White matter . Leukomyelitis.
    The whole crossectional areTranversemyelitis.
    Lesions are multiple and wide spreadOver a long vertical extent..
    DiffuseOr Disseminated.
    Combined meninges and spinal cordMeningomyelitis.
    Combined meninges and root--- meningpradiculitis.
    Inflammatory disease limited to the spinal dura. Pachymeningitis.
    Infected material collects in the epidural or subdural space Epidural
    spinal Or subdural spinal abcess or Granulomatous.

    CLASSIFICATION OF INFLAMMATORY DISEASE


    OF THE SPINAL CORD SEE TRANSPARANTS

    ACUTE TRANSVERSE MYELITIS


    IS

    USUALLY BILATERAL AND TENDS TO


    CAUSE MORE SEVERE WEAKNESS THAN
    THE TYPICAL ATTACKS OF PARTIAL
    MYELITIS.
    The condition may be peri infectious or
    postinfectious process and has been
    associated with many viral infection,
    including poliovirus, echovirus and
    coxsackieviruses.

    Etiologie Transverse myelitis

    1. Congenital vascular malformation


    2. Infectious viral infection
    3. Autoimune- peri or post infection or vaccinial
    myelitis.
    4. Multiple sclerosis
    5. Neoplastic
    6. Toxic- secondary to heroin injection
    7. Vascular
    8. Degenerative- irradiation
    9. Idiopathic.

    PATOLOGI

    JHTMC (John Hopkins Transverse Myelitis Center)


    kondisi inflamasi yang berhubungan dengan
    mekanisme immune-mediated

    Pasien myelitis transversalis perubahan inflamasi


    pada medula spinalisnya

    Abnormalitas patologi ( bervariasi )

    infiltrasi lokal oleh limfosit dan monosit dalam segmen


    medula spinalis dan daerah perivaskuler
    adanya aktifitas yang bervariasi dari mikroglia dan astroglia

    Besar

    dan luasnya gambaran inflamasi


    faktor etiologi dan profile perubahan
    myelopati :

    Myelitis post infeksius perubahan white matter,


    demielinasi, gangguan aksonal
    myelitis transversalis gambaran yang
    melibatkan keduanya secara bersamaan baik
    white maupun grey matter

    Viral causes of acute myelitis


    Herpesvirus:

    HSV2, Varicella Zoster, HSV1,


    Epstein barr, Cytomegalo, human herpes6.
    Enterovirus: Poliovirus, Enterovirus 70,
    Echovirus, Coxsackievirus.
    Arbovirus: west nile virus
    Other: Mumps, HIV, Dengue.

    Affinities virus in myelitis


    Enterovirus

    anterior horn or nuclei of the

    brain stem
    Herpes zoster dorsal root ganglion

    Clinical manifestation
    Acute

    paraplegic or Quadriplegic.
    Urinary retention.
    Sensory disturbances

    Diagnostic prosedure

    CSF examination:
    - mild to moderate lymphocytic pleocytosis (10-1000
    cell/mm3), elevated protein (100-500 mg/dl), and
    normal or mildly depressed glucose level.
    PCR- virus spesific PCR and antibody titer should be
    performed.
    MRI-T2 weighted shows increased signal intensity
    involving gray matter and surronding white matter.

    PROSEDUR DIAGNOSTIK

    Dikutip dari : Transverse Myelitis Consortium Working Group. Proposed


    diagnostic criteria and nosology of acute transverse myelitis. Neurology

    DIAGNOSIS BANDING :

    Multiple sclerosis
    Penyakit sistemik (SLE, Sjorgen disease)
    Venous infarct
    Malformasi vaskuler (fistula AV, AVM, angioma
    kavernosa)
    Fibrocartilagenous embolism
    Myelopati radiasi

    Treatment Viral myelitis


    Antiviral

    treatment:
    Glucocorticoid
    Spasticity: baclofen (lioresal) 10 mg q6h,
    benzodiazepin and tizanidine.

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