All are treatable diseases of spinal cord EXCEPT:
ANSWER: (A) ALSREF: Harrison's 18th ed ch: 377Option (A):ALS or amyotrophic lateral sclerosis : No treatment arrests the underlying pathologic process in ALS. The drug riluzole (100 mg/d) was approved for ALS because it produces a modest lengthening of survival.Option (B):Multiple sclerosis : Therapy for MS can be divided into several categories:treatment of acute attacks,treatment with disease-modifying agents that reduce the biological activity of MS, andsymptomatic therapy. Treatments that promote remyelination or neural repair do not currently exist but would be highly desirableOption (C):Syringomelia: Treatment of syringomyelia is generally unsatisfactory. The Chiari tonsillar herniation is usually decompressed, generally by suboccipital craniectomy, upper cervical laminectomy, and placement of a dural graft. Obstruction of fourth ventricular outflow is reestablished by this procedure. If the syrinx cavity is large, some surgeons recommend direct decompression or drainage by one of a number of methods, but the added benefit of this procedure is uncertain, and morbidity is common.With Chiari malformations, shunting of hydrocephalus should generally precede any attempt to correct the syrinx. Surgery may stabilize the neurologic deficit, and some patients improve.Syringomyelia secondary to trauma or infection is treated with a decompression and drainage procedure in which a small shunt is inserted between the syrinx cavity and the subarachnoid space; alternatively, the cavity can be fenestrated. Cases due to intramedullary spinal cord tumor are generally managed by resection of the tumor.Option (D): A-V Malformations: treatment of AVM is largely surgical.Although the text creates confusion, but a table in Harrisons 18th Ed solves the question. The questions seems to have been taken directly from itTREATABLE SPINAL CORD DISORDERSCompressiveEpidural, intradural, or intramedullary neoplasmEpidural abscessEpidural hemorrhageCervical spondylosisHerniated diskPosttraumatic compression by fractured or displaced vertebra or hemorrhageVascularArteriovenous malformationAntiphospholipid syndrome and other hypercoagulable statesInflammatoryMultiple sclerosisNeuromyelitis opticaTransverse myelitisSarcoidosisSjogren-related myelopathySystemic lupus erythematosusVasculitisInfectiousViral: VZV, HSV-1 and -2, CMV, HIV, HTLV-I, othersBacterial and mycobacterial: Borrelia, Listeria, syphilis, othersMycoplasma pneumoniaeParasitic: schistosomiasis, toxoplasmosisDevelopmentalSyringomyeliaMeningomyeloceleTethered cord syndromeMetabolicVitamin B12 deficiency (subacute combined degeneration)Copper deficiencyAbbreviations: CMV, cytomegalovirus; HSV. herpes simplex virus; HTLV
ALS
Multiple sclerosis
Syringomyelia
A-V malformation
Spinal Cord Diseases