Describe the clinical picture of a patient presenting with a transverse myelopathy myelitis

• Chief complaint is usually lower extremity weakness and ambulatory dysfunction

• If the cervical cord is involved, upper extremity symptoms are also present

• Lhermitte's phenomenon (lightning-like electric shock pain radiating into the extremities and down the spine with neck flexion) may be present

• Sphincter incontinence, sexual dysfunction may be present

• Hoffmann's sign and Babinski's sign may be present

• Loss of abdominal and cremasteric reflexes is common

• Signs of spinal shock (flaccid paralysis with hypotension and bradycardia) may be present

• Treatment with steroids is common, but response is highly variable

• Most common type is idiopathic transverse myelitis

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