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Clinical and MRI phenotypes of sarcoidosis-associated myelopathy

Murphy, Olwen C ; Salazar-Camelo, Andrea ; Jimenez, Jorge A ; Barreras, Paula ; Reyes, Maria I ; Garcia, Maria A ; Moller, David R ; Chen, Edward S ; Pardo, Carlos A

Neurology : neuroimmunology & neuroinflammation, 2020-07, Vol.7 (4), p.e722-e722 [Periódico revisado por pares]

United States: American Academy of Neurology

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Título:
Clinical and MRI phenotypes of sarcoidosis-associated myelopathy
Autor: Murphy, Olwen C ; Salazar-Camelo, Andrea ; Jimenez, Jorge A ; Barreras, Paula ; Reyes, Maria I ; Garcia, Maria A ; Moller, David R ; Chen, Edward S ; Pardo, Carlos A
Assuntos: Adult ; Central Nervous System Diseases - cerebrospinal fluid ; Central Nervous System Diseases - diagnostic imaging ; Central Nervous System Diseases - pathology ; Female ; Humans ; Leukocytosis - cerebrospinal fluid ; Magnetic Resonance Imaging ; Male ; Meningitis - cerebrospinal fluid ; Meningitis - diagnostic imaging ; Meningitis - pathology ; Middle Aged ; Myelitis - cerebrospinal fluid ; Myelitis - diagnostic imaging ; Myelitis - pathology ; Radiculopathy - cerebrospinal fluid ; Radiculopathy - diagnostic imaging ; Radiculopathy - pathology ; Retrospective Studies ; Sarcoidosis - cerebrospinal fluid ; Sarcoidosis - diagnostic imaging ; Sarcoidosis - pathology ; Spinal Cord Diseases - cerebrospinal fluid ; Spinal Cord Diseases - diagnostic imaging ; Spinal Cord Diseases - pathology
É parte de: Neurology : neuroimmunology & neuroinflammation, 2020-07, Vol.7 (4), p.e722-e722
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Go to Neurology.org/NN for full disclosures. Funding information is provided at the end of the article.
The Article Processing Charge was funded by the authors.
Descrição: OBJECTIVETo determine the characteristic clinical and spinal MRI phenotypes of sarcoidosis-associated myelopathy (SAM), we analyzed a large cohort of patients with this disorder. METHODSPatients diagnosed with SAM at a single center between 2000 and 2018 who met the established criteria for definite and probable neurosarcoidosis were included in a retrospective analysis to identify clinical profiles, CSF characteristics, and MRI lesion morphology. RESULTSOf 62 included patients, 33 (53%) were male, and 30 (48%) were African American. SAM was the first clinical presentation of sarcoidosis in 49 patients (79%). Temporal profile of symptom evolution was chronic in 81%, with sensory symptoms most frequently reported (87%). CSF studies showed pleocytosis in 79% and CSF-restricted oligoclonal bands in 23% of samples tested. Four discrete patterns of lesion morphology were identified on spine MRIlongitudinally extensive myelitis (n = 28, 45%), short tumefactive myelitis (n = 14, 23%), spinal meningitis/meningoradiculitis (n = 14, 23%), and anterior myelitis associated with areas of disc degeneration (n = 6, 10%). Postgadolinium enhancement was seen in all but 1 patient during the acute phase. The most frequent enhancement pattern was dorsal subpial enhancement (n = 40), followed by meningeal/radicular enhancement (n = 23) and ventral subpial enhancement (n = 12). In 26 cases (42%), enhancement occurred at locations with coexisting structural changes (e.g., spondylosis). CONCLUSIONSRecognition of the clinical features (chronically evolving myelopathy) and distinct MRI phenotypes (with enhancement in a subpial and/or meningeal pattern) seen in SAM can aid diagnosis of this disorder. Enhancement patterns suggest that SAM may have a predilection for areas of the spinal cord susceptible to mechanical stress.
Editor: United States: American Academy of Neurology
Idioma: Inglês

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Clinical and MRI phenotypes of sarcoidosis-associated myelopathy

Murphy, Olwen C ; Salazar-Camelo, Andrea ; Jimenez, Jorge A ; Barreras, Paula ; Reyes, Maria I ; Garcia, Maria A ; Moller, David R ; Chen, Edward S ; Pardo, Carlos A

United States: American Academy of Neurology

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