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Wallerian degeneration as a mimic of recurrence of myelitis
  1. Arpan Patel1,
  2. Prateeka Koul1,
  3. Asaff Harel1,2
  1. 1 Neurology, North Shore University Hospital, Manhasset, New York, USA
  2. 2 Neurology, Lenox Hill Hospital, New York, New York, USA
  1. Correspondence to Dr Asaff Harel, Neurology, Lenox Hill Hospital, New York, NY 10075, USA; asaffh{at}


A middle-aged woman with idiopathic longitudinally extensive myelitis underwent repeat MR scan of cervical spine at 5-month follow-up, which showed new non-enhancing T2 hyperintensities, initially reported as myelitis recurrence. However, the hyperintensities involved both lateral corticospinal tracts caudal to the initial lesion and both dorsal columns rostral to the initial lesion and were therefore compatible with Wallerian degeneration. This radiological mimic should be considered in the differential of recurrence of myelitis.

  • neuroimmunology
  • MRI
  • image analysis
  • clinical neurology
  • myelopathy

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  • Contributors AP and PK were involved in acquisition and interpretation of the data and drafting and critical revision of the manuscript. AH was involved in acquisition and interpretation of the data and critical revision and finalisation of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests AH has received fees from Teva, Biogen, Alexion and Banner Life Sciences.

  • Provenance and peer review Not commissioned. Externally peer reviewed by Emma Tallantyre, Cardiff, UK, and Jackie Palace, Oxford, UK.

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    Geraint N Fuller Phil E M Smith

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