Chapter

Spinal Cord Syndromes

Robert B. Darnell and Jerome B. Posner

in Paraneoplastic Syndromes

Published on behalf of Oxford University Press

Published in print April 2010 | ISBN: 9780199772735
Published online April 2013 | e-ISBN: 9780199322916 | DOI: http://dx.doi.org/10.1093/med/9780199772735.003.006

Series: Contemporary Neurology Series

Spinal Cord Syndromes

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Because the spinal cord is the caudal continuation of the brain, paraneoplastic myelopathies usually occur as part of a more widespread paraneoplastic encephalomyelitis, particularly in patients with the anti-Hu antibody.1 However, occasionally a paraneoplastic syndrome affects the spinal cord alone or causes symptoms suggesting isolated spinal cord involvement, even when pathologic abnormalities involve other portions of the nervous system. Myelopathies may affect all of the structures within a segment of spinal cord (transverse myelopathy)2 or occur in a specific area of the spinal cord, as, for example, anterior horn cells. Different myelopathies may have different pathologies. Some are inflammatory, some necrotic, some apoptotic. At times, symptoms of spinal cord dysfunction occur without evident pathology. Taken together, paraneoplastic myelopathies are rare. Table 6–1 classifies the spinal cord syndromes. The classification of transverse and even focal myelopathies given here is somewhat arbitrary. For example, necrotizing myelopathy may contain inflammatory cells, and patients with inflammatory myelitis may occasionally show areas of necrosis. The difference lies in the degree of the given findings. In paraneoplastic Devic syndrome, both demyelination and necrosis are found. The difference between transverse myelopathy and widespread focal myelopathies is also arbitrary. Nevertheless, we find this classification clinically and, to some degree, pathogenetically useful.

Chapter.  18385 words.  Illustrated.

Subjects: Neurology

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