Myelopathy is sometimes confused for and misdiagnosed as a condition known as radiculopathy. While myelopathy is compression of the spinal cord itself, radiculopathy is compression of the nerve roots that branch off from the spine and run to other parts of the body.
Cervical myelopathy is part of ALS mimic syndrome and should be considered in patients with clinical signs of motor neuron disease.
MRI scans are the preferred diagnostic method for cervical myelopathy, but other methods can also be used to help rule out other conditions. Cervical myelopathy is best treated with spine decompression surgery.
Symptoms of Myelopathy
Pain in the lower back, neck, arm or leg. Tingling, numbness or weakness. Decreased fine motor skills, balance, and coordination. Abnormal or increased reflexes in extremities.
Since cervical myelopathy is an upper motor neuron syndrome, the EMG is expected to display a normal finding unless there are intervening root or peripheral nerve problems.
A magnetic resonance image (MRI) is considered the best imaging method for confirming the presence of spinal canal stenosis, cord compression, or myelomalacia, elements germane to cervical spine myelopathy. MRI of the cervical spine can also rule out spinal cord tumours.
Several tests may need to be performed to rule out other potential spinal cord diseases. Testing may include a neurological exam, blood work, X-rays, MRI or CT scan, and spinal fluid analysis. Genetic testing will show if a patient has one or two copies of the variants associated with the development of DM.
Cervical myelopathy occurs in the neck and is the most common form of myelopathy.
The presenting features of cervical myelopathy (cord compression) are often non-specific — symptoms such as clumsiness of hands and feet, decreased manual dexterity, and an unsteady gait. Cervical pain may be present but its absence does not exclude this diagnosis.
Symptoms of myelopathy depend on which part of the spinal cord is affected. Some common symptoms include: Pain in your neck or back. Tingling, numbness or weakness in your arms, hands, legs or feet.
How quickly does degenerative myelopathy progress? Unfortunately DM tends to progress very quickly. Most dogs that have been diagnosed with degenerative myelopathy will become paraplegic within six months to a year.
Degenerative cervical myelopathy (DCM) and multiple sclerosis (MS) are two common conditions with distinctive pathophysiology but overlapping clinical manifestations which may include myelopathy, motor/sensory disturbances, and bowel/bladder dysfunctions.
The important thing to remember with degenerative myelopathy is that the condition itself is not painful to the dog, but is more “painful” for the owner to watch. If you have a dog with degenerative myelopathy it is important to remember that it's about the quality of your dog's life and not the quantity of the days.
Abstract. Background: Patients with degenerative cervical myelopathy (DCM) often present with atypical symptoms such as vertigo, headache, palpitations, tinnitus, blurred vision, memory loss, and abdominal discomfort.
Foramen magnum and upper cervical cord lesions
The wasting (“remote atrophy”), weakness, and areflexia may suggest the involvement of cervical cord segments well below the level of the foramen magnum lesion, hence are false localising.
The most common cause of myelopathy is when the spinal cord is compressed, or squeezed. This compression disrupts normal nerve transmission. Arthritis of the spine, or spondylosis is the most common reason the spinal cord is compressed. Spondylosis refers to degenerative, or age-related, changes in the spine.
Cervical myelopathy is a serious condition affecting the cervical spine, and if left untreated it can lead to significant and permanent nerve damage including paralysis and death. In most cases, this is an urgent surgical condition.
According to the study results, (1) the cervical spondylotic myelopathy patients exhibited regional neural impairments, which correlated with the severity of cognitive deficits in the DMN brain regions, and (2) the increased FC and global efficiency of DMN can compensate for the regional impairment.
Average survival was 15.3 years (± interquartile range 7.5) and ranged from 0.3 to 24.9 years.
Pain, cramps, weakness or numbness in the arms, hands and legs. Paralysis. Poor coordination. Fatigue.
We should note that MRI is considered as the golden standard to diagnose myelopathy. Physical examination results commonly in long tract signs such as spasticity, hyperreflexia and abnormal reflexes. Hoffmann, Babinski, and clonus are frequently tested reflexes.
Sadly, the prognosis for dogs with DM is poor. Without any intervention, most dogs will become paralyzed in 6-12 months, and the disease will continue to progress. When the front limbs start showing symptoms, end of life care and humane euthanasia are strongly recommended.
Studies in people with a similar condition, Lou Gehrig's disease, have shown that an advanced MRI technique called diffusion tensor imaging is able to detect the microscopic changes in the spinal cord caused by this condition.
This disease is not uncommon in some pure bred dogs with an overall prevalence rate of 0.19%. Although the German Shepherd Dog is the most commonly affected breed, DM has been reported in other breeds and most recently in the Pembroke Welsh Corgi (PWC).