Myelopathy but normal MRI: where next?

• Published in: Practical neurology Vol. 8; no. 2; pp. 90 - 102
• Main Authors: Wong, S H, Boggild, M, Enevoldson, T P, Fletcher, N A
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd 01.04.2008; BMJ; BMJ Publishing Group LTD
• Subjects: Adolescent; Aged; Biological and medical sciences; Blood tests; Blood transfusions; Brain - pathology; Catheters; Diagnosis, Differential; Dystonia; Fatty acids; Female; Fistula; Gait; Humans; Investigative techniques, diagnostic techniques (general aspects); Magnetic Resonance Imaging; Male; Medical imaging; Medical sciences; Middle Aged; Nervous system; Proprioception; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Spasticity; Spinal cord; Spinal Cord - pathology; Spinal Cord Diseases - diagnosis; Urinary incontinence; Walking; Myelopathy; Nervous system diseases; Spinal cord disease; Nuclear magnetic resonance imaging; Central nervous system disease
• ISSN: 1474-7758; 1474-7766
• DOI: 10.1136/jnnp.2008.144121

For most patients presenting with a spinal cord syndrome MR scanning has become the key investigation in establishing the diagnosis. However, myelopathy with normal spinal imaging remains a common clinical conundrum. In this review we discuss the diagnoses to consider for the neurologist presented with a patient with “MR normal myelopathy”. We will illustrate this scenario with a series of short cases and consider the further investigation of “MRI normal” myelopathy.