Dr Carlo Pardo Grand Rounds: Myelitis and Myelopathies, Part 1

RUSK Insights on Rehabilitation Medicine

A special two-part Grand Rounds presentation by Dr. Carlo Pardo, who is a clinical neurologist/pathologist and professor of neurology and pathology at the Johns Hopkins School of Medicine.

Part One

He began by stating that the main objective of this presentation is understanding the concept of myelopathies versus myelitis. He wants to present a diagnostic approach for the evaluation of a patient with an acute case of myelopathy and vascular myelopathy, and review the current concepts of vascular myelopathies, something that probably will be encountered very often in rehabilitation clinical practice. It is truly important that after this lecture to stop using the term myelitis and instead use a more precise etiological diagnosis of myelopathy. He disclosed where his research funding comes from. He presented a historical concept of myelitis and myelopathies. In the past several years, the major revolution in neurology has been the discovery of many biomarkers that are identified myelopathies. Etiological diagnosis should dominate the evaluation of patients with acute myelopathies because once we identify the etiological factor, we are able to help those patients in a better way. A lack of proper characterization may lead to mistreatment. A major difficulty in assessment of non-inflammatory myelopathy is at this moment, we do not have clear criteria to diagnose some of them. So keep in mind that the temporal assessment of the lesion by MRI is also important and you need to think about the timing of the MRI when you are preparing to give an interpretation to decide what is a potential etiological diagnosis.