Neurológia pre prax 3/2023

Autoimmune myelitis

Autoimmune myelitis represents an etiologically heterogeneous group of inflammatory disorders of the spinal cord with acute or subacute onset. For a correct diagnosis, evaluation of objective findings and urgent imaging examinations (MRI of the spinal cord and brain, or at least CT if contraindicated) are essential. The examination of cerebrospinal fluid (especially to decide on infectious or other etiology), or other auxiliary examinations including determination of organ-specific and non-specific autoantibodies, plays an indispensable role. Once an infectious etiology has been ruled out, autoimmune inflammations affecting the CNS (multiple sclerosis, neuromyelitis optica and diseases of its broader spectrum, diseases associated with antibodies to myelin oligodendrocyte glycoprotein, systemic connective tissue diseases, and others), including paraneoplastic myelopathies and neurosarcoidosis, are considered. In some cases, oncoscreening should be added. Despite extensive investigation, the etiology remains unknown in some cases (idiopathic myelitis).

Keywords: myelitis, autoimmune disease, multiple sclerosis, neuromyelitis optica