Post-infective transverse myelitis following Streptococcus pneumoniae meningitis with radiological features of acute disseminated encephalomyelitis: a case report

Table 1 Diagnostic criteria for acute transverse myelitis

Inclusion criteria	Exclusion criteria	Disease associated features
Development of sensory, motor or autonomic dysfunction attributable to the spinal cord	History of spinal irradiation in the last 10 years	Serological or clinical evidence of a systemic autoimmune disorder
Bilateral signs and/or symptoms (not necessarily symmetrical)	Clear arterial distribution of the clinical deficit suggesting anterior spinal artery thrombosis	Central nervous system (CNS) manifestation of syphilis, Lyme disease, HIV, human T-lymphotropic virus 1 (HTLV-1), mycoplasma, other viral infections
Exclusion of extra-axial compressive etiology by magnetic resonance imaging (MRI) or myelography	Abnormal flow void on the surface of the spinal cord consistent with arteriovenous malformation	Abnormalities on brain MRI scans suggestive of multiple sclerosis (MS) or acute disseminated encephalomyelitis (ADEM)
Inflammation within the spinal cord demonstrated by cerebrospinal fluid (CSF) pleocytosisor elevated IgG index or gadolinium enhancement		History of clinically apparent optic neuritis
Peak severity reached between four hours and 21 days after onset

Table modified from the Transverse Myelitis Consortium Working Group [1]. All of the inclusion criteria must be present, and all of the exclusion criteria absent, for a diagnosis of acute transverse myelitis to be made. In the absence of disease associated features the transverse myelitis is deemed idiopathic; in their presence it is deemed disease associated.

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