Longitudinally extensive spinal cord lesions (LESCL), also known as longitudinally extensive transverse myelitis (LETM), represent extensive involvement of the spinal cord, with abnormal T2 signal traversing at least three vertebral body segments in length.
Differential diagnosis
They are typical of neuromyelitis optica (NMO) but can be seen in a number of other conditions, including 1-4:
- neuromyelitis optica (NMO)
-
multiple sclerosis
- confluent short segment lesions mimicking LESCL
- anti-MOG associated encephalomyelitis
- autoimmune GFAP astrocytopathy
- systemic illness
- other causes of transverse myelitis
- idiopathic (aquaporin-4 negative)
- post-infectious
- vascular