Acute Myelopathy from ADEM to Zika

D.J. Alden, S.G. Alden, and B.Y. Huang

View Article on Neurographics Website

Date of Activity Release: March 19, 2019
Date of Activity Expiration: March 19, 2022

Target Audience:
Intended for neuroradiologists and neuroradiology trainees with varying degrees of experience.

Learning Objective:
To recognize spine abnormalities on MR imaging and identify circumstantial clinical and demographic features that can narrow or isolate the differential diagnosis in patients who present with acute or progressive myelopathy.

Acute-onset extremity weakness and paresthesia are among the most common indications for emergent spinal MR imaging. The aim of this article is to broaden readers’ differential diagnostic armamentarium and reporting accuracy in the setting of suspected acute or progressive myelopathy by presenting a review of common and uncommon causes of spinal cord disease with a focus on key distinguishing clinical and imaging findings organized into related groups of diseases. The review covers spinal cord anatomy; discusses typical MR imaging findings in various nontraumatic etiologies of myelopathy and spinal neuropathy, as well as specific MR imaging findings; and examines the imaging, demographic, and clinical factors that can help us condense otherwise nonspecific findings into a focused differential or a single, discrete diagnosis. Topics covered include vascular, infectious and postinfectious, granulomatous, neoplastic, compressive, demyelinating, and toxic and metabolic diseases. Review of this material can increase our confidence in rendering a targeted diagnosis or differential diagnosis and can make a significant impact on the downstream work-up and treatment of the patient.

Commercial Support
No commercial support was received for this activity.

Credit Designation Statement

The American Society of Neuroradiology is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The American Society of Neuroradiology designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 Credit(s)TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Method of Physician Participation:
Each participant will review the corresponding Neurographics article located at Upon completion, each physician will complete and pass a post-test with a score of at least 80% to receive a CME certificate.

All individuals in control of content have disclosed the following relevant financial relationships. All of these relationships were treated as a conflict of interest, and have been resolved (C7 SCS 6.1-6.2, 6.5)

Authors have no relevant financial relationships.





Barton Branstetter 

Editor in Chief

None, N/A

Adam Flanders

Deputy Editor

Royalties, Lippincott Williams and Wilkins

Robert Quencer 

Consulting Editor

None, N/A

Mark Mullins

Associate Editor

Non-remunerative position, AUR6

Meng Law

Associate Editor

Stockholder, Clinical Imaging

Edward Escott

Associate Editor

Grant, Atherysys, Inc.; Royalties, Thieme Medical Publishers

Scott Faro

Associate Editor

None, N/A

Tina Young Poussaint

Associate Editor

None, N/A

Dheeraj Ghandi

Associate Editor

Grant, Arstasis, Axera Inc.; Consultant, Covidien, EV3

Contact Information:
If you have questions regarding this enduring material activity, please contact us at

Privacy Policy and Confidentiality Policy:
The ASNR does not share your personal information provided to this site with any third party, except where required by CME governing bodies for verification of CME activities. Your email address will only be used to contact you in relation to your activities on the website, except where you have given ASNR permission to contact you with additional information. ASNR adheres to the same policy for members as nonmembers, except that: ASNR member mailing address information may be shared with providers of accredited CME activities.

Copyright © American Society of Neuroradiology, 2011-2019