Distinguishing cervical transverse myelitis with spinal shock from Guillian Barre syndrome is that in the
Sharp level of demarcation of sensory and motor symptoms exist.
Hypotonia
Decreased stretch and superficial reflexes
Absent Neuropathic pain
(A) Sharp level of demarcation of sensory and motor symptoms existb> Well defined transverse level on trunk - below which there is sensory and motor loss is a feature of spinal cord lesion.> Transverse myelitis is sometimes manifested as rapid-onset, severe paraparesis or quadriparesis with areflexia, which may lead to diagnostic con-fusion with other causes of ascending weakness,such as the Guillain-Barre syndrome; otherwise, hyperreflexia and Babinski signs are present, con-firming a central rather than a peripheral cause of the muscle weakness. A well-defined truncal sensory level, below which the sensation of pain and temperature is altered or lost, distinguishes myelopathy from cerebral lesions and peripheral neuropathies.> Neuropathic pain may occur in the midline (an aching, deep pain) or in a dermatomal distribution (radicular or lancinating pain or a sensation of burning or itching), with the latter pattern providing a clue to the anatomical level of the lesion.
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