EDITOR’S PREFACE

Traversing the
Not-Always-Transverse
Myelopathies

This issue of Continuum is devoted to the diagnosis and management

of diseases that affect the spinal cord or the cauda equina, disorders
that can lead to profound disability but can often be ameliorated or
reversed with expeditious diagnosis and appropriate therapy. I am so
appreciative of Dr Eoin P. Flanagan for his skillful guest editorship,
including his enlistment of outstanding content-expert authors and his
meticulousness throughout all phases of the issue’s development.

The issue begins with the article by Dr Todd A.
Hardy, who provides a detailed review of anatomy
and localization of the spinal cord, conus medullaris,
and cauda equina, basic neuroanatomic principles
that are key to our clinical assessment of disorders
affecting any of these regions. In the next article,
Dr Nicholas L. Zalewski discusses the diagnosis and
management of vascular disorders that cause spinal
cord dysfunction, such as from infarction, venous
congestion, or hemorrhage.
Drs Sebastian Lopez Chiriboga and Flanagan next
discuss the rapidly evolving concepts regarding
disorders that cause inflammation of the spinal cord
(myelitis), including aquaporin-4-IgG–seropositive
neuromyelitis optica spectrum disorders (NMOSD),
myelin oligodendrocyte glycoprotein
(MOG)-IgG–associated disease, multiple sclerosis,
paraneoplastic myelopathies, and other autoimmune
myelitides, syndromes that are often not fully
“transverse” in cross-sectional spinal cord involvement
despite the commonly associated adjective. In the
following article, Dr Michel Toledano discusses the
many disorders of the spinal cord and cauda equina that
can occur because of infections. Dr Amy A. Pruitt
then provides a thorough review of the diagnosis and
current management of the myelopathies that are
caused by primary or metastatic neoplasms affecting
the spinal cord.
Dr Natalie Elizabeth Parks next reviews the many
myelopathies that can occur because of metabolic
and toxic disorders affecting the spinal cord, entities
so important to consider in our differential diagnosis
of progressive, and potentially reversible, spinal cord
dysfunction. In the next article, Dr Shamik
Bhattacharyya reviews the numerous structural spine
disorders that can result in spinal cord dysfunction
and for which neurologists are key in helping assess
the role of neurosurgical consultation and
intervention. Dr John K. Fink then reviews and
updates us on the various hereditary disorders whose
manifestations include, but are often not limited to,
spinal cord dysfunction.
Leaving the spinal cord, literally and figuratively,
the next article by Dr Samantha LoRusso discusses
the disorders that can affect the cauda equina,
whether from compression (a neurosurgical
emergency) or one of the myriad other potential
causes of cauda equina dysfunction.

10 FEBRUARY 2021

Copyright © American Academy of Neurology. Unauthorized reproduction of this article is prohibited.

 In the final review article of the issue, Drs Felix E.
Diehn and Karl N. Krecke provide an encyclopedic
review of neuroimaging clues to the diagnosis of the
multitude of disorders that can affect the spinal cord
and cauda equina, with many instructive
representative images.
After reading the issue and taking the Postreading
Self-Assessment and CME Test written by Drs
Douglas J. Gelb and Allyson R. Zazulia, readers may
earn up to 20 AMA PRA Category 1 CreditsTM toward
self-assessment CME or, for Canadian participants, a
maximum of 20 hours toward the Self-Assessment
Program (Section 3) of the Maintenance of
Certification Program of the Royal College of
Physicians and Surgeons of Canada. Additional credit
can be obtained by listening to Continuum Audio
I am so appreciative of Dr Eoin P.
Flanagan for his skillful guest
editorship, including his enlistment
of outstanding content-expert
authors and his meticulousness
throughout all phases of the issue’s
development.
CONTINUUMJOURNAL.COM
Copyright © American Academy of Neurology. Unauthorized reproduction of this article is prohibited.
interviews associated with this and other Continuum
issues, available to all subscribers, and completing
tests on the Continuum Audio web platform or
mobile app. Continuum Audio is also accredited
by the Royal College of Physicians and Surgeons
of Canada.
This issue, as well as the October and December
2020 issues, are part of a pilot program of Continuum
issues read aloud. Different from Continuum Audio,
these are recordings read verbatim from the print
articles by Dr Michael Kentris, a neurologist at the
Clinical Neuroscience Institute in Dayton, Ohio. The
audio files are available to all Continuum subscribers
in the AAN’s Online Learning Center at continpub.
com/CME. I encourage you to listen and submit the
survey with your feedback on this pilot.
My sincerest thanks to Dr Flanagan for his
remarkable guest editorship of this issue and for his
hands-on devotion to creating such a well-organized
and well-illustrated (with representative
neuroimages) volume to help us navigate the
complexities of the many patients who present with
dysfunction of the spinal cord or cauda equina.
—STEVEN L. LEWIS, MD, FAAN
EDITOR-IN-CHIEF
© 2021 American Academy of Neurology.
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