Transverse myelitis electrocardiogram

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Julinka Auta Fernandes

Overview

  • There is no established disease-specific finding on an electrocardiogram (ECG) for transverse myelitis.
  • ECG is not a diagnostic study of choice for transverse myelitis and must not be used to confirm or exclude the diagnosis. Major published diagnostic consensus statements do not assign ECG a role in the diagnostic criteria or core diagnostic evaluation of transverse myelitis.[1][2]

Electrocardiogram

Role of electrocardiography in transverse myelitis
Clinical question Evidence-based interpretation
Characteristic ECG finding None established.
Diagnostic performance Diagnostic sensitivity, specificity, and predictive values have not been established because ECG is not a diagnostic test for transverse myelitis.
Routine use A resting 12-lead ECG is not recommended solely to diagnose transverse myelitis.
Targeted use ECG may be obtained for an independent cardiac, general medical, or treatment-monitoring indication. Its purpose in these circumstances is evaluation of the concurrent issue, not diagnosis of transverse myelitis.

Clinical interpretation

  • If ECG is performed for an independent indication, interpret any abnormality according to that indication; the finding is nonspecific for transverse myelitis.
  • ECG findings must not be used to satisfy or exclude any diagnostic criterion for transverse myelitis.
  • No ECG tracing should be presented as confirmatory of transverse myelitis.


References

  1. ↑ Transverse Myelitis Consortium Working Group. Proposed diagnostic criteria and nosology of acute transverse myelitis. Neurology. 2002;59(4):499-505. doi:10.1212/WNL.59.4.499. PMID: 12236201.
  2. ↑ Jarius S, Aktas O, Ayzenberg I, et al.; Neuromyelitis Optica Study Group. Update on the diagnosis and treatment of neuromyelitis optica spectrum disorders—revised recommendations of the Neuromyelitis Optica Study Group. Part I: Diagnosis and differential diagnosis. Journal of Neurology. 2023;270(7):3341-3368. doi:10.1007/s00415-023-11634-0. PMID: 37022481.