It is an acute non-suppurative inflammation of the spinal cord, possibly an autoimmune disease caused by viral infection.

bubble_chart Diagnosis

1. Medical History and Symptoms:

Mostly occurs in young adults, with symptoms of upper respiratory infection or a history of vaccination within two weeks before onset. Triggers include cold exposure, overwork, trauma, etc. Initial symptoms include numbness and weakness in both lower limbs, back pain and a girdle-like sensation in the corresponding lesion area, urinary retention, and fecal incontinence.

2. Physical Examination Findings:

Manifestations of transverse spinal cord injury:

1. In the early "spinal shock phase," flaccid paralysis is observed. After the shock phase (3-4 weeks), the limbs below the lesion level exhibit upper motor neuron paralysis.

2. Loss of deep and superficial sensations below the lesion level, with possible hyperesthesia at the lesion level in some cases.

3. Autonomic dysfunction: Manifested as urinary retention, significant residual urine, overflow incontinence, fecal incontinence. After the shock phase, reflexive bladder, severe constipation, and priapism may occur.

3. Auxiliary Examinations:

1. Peripheral white blood cell count is normal or slightly elevated during the acute phase.

2. Cerebrospinal fluid pressure is normal; some patients show grade I increase in white blood cells and protein, with normal glucose and chloride levels.

3. Spinal MRI reveals thickening and abnormal signal intensity in the affected spinal cord area.

4. Differential Diagnosis:

Needs to be distinguished from acute epidural abscess, spinal subcutaneous nodules, spinal metastatic tumors, neuromyelitis optica, and spinal cord hemorrhage.

1. In the early stage, administer 100-200mg of hydrocortisone or 5-10mg of dexamethasone intravenously once daily. If the condition stabilizes after 7-10 days, switch to oral prednisone at 30mg. The dosage can be gradually reduced as the condition improves.

2. Use 250ml of 20% mannitol intravenously once daily for dehydration, and 500ml of 706 plasma substitute intravenously once daily to improve spinal microcirculation.

3. Administer high-dose vitamin B complex preparations and neurotrophic drugs such as citicoline.

4. Appropriately select antibiotics to prevent respiratory and urinary tract infections.

5. Turn the patient regularly and perform back patting to prevent bedsores. Strengthen functional exercises of the affected limbs to prevent limb deformities.