Spinal cord compression differential diagnosis

Spinal Cord Compression Microchapters
Home
Patient Information
Overview
Pathophysiology
Causes
Differentiating Spinal Cord Compression from other Diseases
Epidemiology and Demographics
Risk Factors
Natural History, Complications and Prognosis
Diagnosis
History and Symptoms
Physical Examination
Laboratory Findings
X Ray
CT
MRI
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Spinal cord compression differential diagnosis On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Spinal cord compression differential diagnosis All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Spinal cord compression differential diagnosis
CDC on Spinal cord compression differential diagnosis
Spinal cord compression differential diagnosis in the news
Blogs on Spinal cord compression differential diagnosis
Directions to Hospitals Treating Spinal cord compression
Risk calculators and risk factors for Spinal cord compression differential diagnosis

Differentiating Spinal Cord Compression from other Diseases

Acute Spinal cord compression presents with paralysis along with pain, it must be differentiated from other diseases that present with similar complaints such as muscle weakness and back pain. Transverse myelitis, GBS(Guillian-Barrie syndrome), HIV-myopathy, diabetic neuropathy, multiple sclerosis(MS), amyotrophic lateral sclerosis(ALS) and peripheral neuropathies are some of the diseases to be considered. The following table describes the differentiating signs and symptoms from a acute spinal cord compression.

Disease/Condition	Differentiating Signs/Symptoms	Differentiating Tests
		CSF Findings	Other diagnostic tests
Transverse myelitis	Febrile illness preceding the symptoms LE >UE	Pleocytosis ↑Total protein	Focal demyelination on MRI
Guillain-Barre syndrome (GBS)	History of gastroenteritis or influenza-like illness Ascending paralysis Loss of deep tendon reflexes Respiratory muscle weakness requiring ventilation	Albumin-cytologic dissociation ↑Total protein	EMG shows decreased conduction Seropositive for Campylobacter jejuni (50% cases)
HIV-related myelopathy	History of HIV infection Paraparesis, spasticity or ataxia (or both) coupled with dementia	Nonspecific	ELISA + followed by confirmation with Westeren blot.
Amyotrophic lateral sclerosis (ALS)	Combination of UMN and LMN Muscle weakness and stiffness as the initial symptoms	Nonspecific	Fibrillation potentials and positive sharp waves, with fasciculation potentials on EMG
Multiple sclerosis	Mimic clinical symptoms of spinal, compression, however, all cases involve the brain. Presents with multiple episodes separated by space with self-resolution Visual symptom (neuromyelitis optica) distinct for MS	↑ IgG and oligobands	MRI brain shows areas of demyelination.
Diabetic neuropathy	History of diabetes mellitus. Pain and loss of sensation in the feet in a glove-and-stocking distribution. Bladder dysfunction may be present due to autonomic neuropathy.	Nonspecific	EMG shows reduction in sensory nerve conduction and a decrease in amplitude.
Polymyositis	Symmetrical weakness of shoulder and pelvic girdles.	Nonspecific	EMG include spontaneous fibrillations, low-amplitude short-duration polyphasic motor potentials Muscle biopsy shows immune cell infiltration and destruction of muscle fibers
Hereditary muscular dystrophy	Proximal and distal muscle weakness Without sensory changes in the initial stages.	Nonspecific	MRI and EMG/nerve conduction studies will show only myopathic changes