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Introduction Introduction
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Aetiology and pathogenesis Aetiology and pathogenesis
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Clinical features Clinical features
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Motor symptoms Motor symptoms
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Sensory symptoms Sensory symptoms
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Autonomic symptoms Autonomic symptoms
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Intramedullary versus extramedullary myelopathy Intramedullary versus extramedullary myelopathy
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False localizing signs False localizing signs
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Differential diagnosis Differential diagnosis
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Clinical investigations Clinical investigations
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Criteria for diagnosis Criteria for diagnosis
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Structural disorders Structural disorders
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Demyelinating diseases Demyelinating diseases
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Inflammatory and infective diseases Inflammatory and infective diseases
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Metabolic and nutritional disorders Metabolic and nutritional disorders
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Hereditary disorders Hereditary disorders
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Vascular disorders of the spinal cord Vascular disorders of the spinal cord
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Treatment and prognosis Treatment and prognosis
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Further reading Further reading
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24.13.1 Diseases of the spinal cord
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Published:January 2020
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Abstract
The spinal cord is subject to numerous pathological processes which may be intrinsic (intramedullary) and/or extrinsic (extramedullary) to the cord. Many diseases can affect the spinal cord. Those of particular note include spondylotic myelopathy, multiple sclerosis, transverse myelitis, subacute combined degeneration of the cord, genetic and vascular disorders, syringomyelia, injury/trauma, motor neuron disease, and cancer—the most common spinal cord tumours are metastasis, astrocytoma, ependymoma, lymphoma. Specific medical and surgical treatments are determined by the particular cause of myelopathy. These may arrest progression, but function that has been lost may not recover fully. Prognosis of acute cord compression is directly related to the time delay between symptom onset and relief of compression. Chronic disability as a consequence of spinal cord disease requires intensive neurorehabilitation.
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