Diagnosis:
Clinical features, plus exclusion of other causes
Clinical features:
Recent or distant exposure to radiation
+signs of myelopathy: Lhermitte’s sign, Brown-Sequard lesion is classic
Acute or insidious onset. Transient & progressive forms
Findings on Investigations:
MRI:
- Radiation change in the vertebra; increased signal
- Normal initially
- Later: T1 hypointese, T2/FLAIR hyperintense, enhances,
CSF: raised protein
SSEP: spinal conduction velocity block
Pathology:
Spectrum: demyelination, Wallarian degeneration of axons, necrosis
Fibrinoid necrosis of vessels, hemorrhage
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