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Arch Neurol. 2012 Mar;69(3):357-62. doi: 10.1001/archneurol.2011.949.

Long-term follow-up of acute partial transverse myelitis.

Author information

1
Service de Neurologie, Hôpital Charles Nicolle, 1 rue de Germont, Rouen Cedex, France. bertrandbourre@gmail.com

Erratum in

  • Arch Neurol. 2012 Jun;69(6):789. Outerryck, Olivier [corrected to Outteryck, Olivier].

Abstract

BACKGROUND:

Acute partial transverse myelitis (APTM) may be the first clinical symptom of multiple sclerosis (MS) or may remain a monophasic event.

OBJECTIVES:

To evaluate the risk of conversion to MS and long-term disability, and to determine prognosis factors for disability.

DESIGN:

We identified patients with no previous history of neurological disease who experienced APTM between January 1998 and December 2005 and were followed up at 3 university hospitals in France. Data on the patients' demographics and clinical states during follow-up, as well as data on cerebrospinal fluid (CSF) analysis, brain and spinal cord magnetic resonance imaging (MRI), and visual evoked potentials, were analyzed.

SETTING:

Neurology departments of 3 university hospitals in Lille, Strasbourg, and Rouen, France, respectively.

PATIENTS:

A total of 85 patients with no previous history of neurological disease who experienced APTM.

RESULTS:

The mean (SD) follow-up period was 104.8 (29.8) months. There were 57 women (67%) and 28 men (33%), with a mean (SD) age at onset of 36.7 (11.7) years. At the end of follow-up, 53 patients (62%) were classified as having MS with a mean (SD) Expanded Disability Status Scale score of 2.6 (1.8), 1 patient (1%) was classified as having postinfectious myelitis, 1 (1%) as having neuromyelitis optica, 1 (1%) as having Sjögren syndrome, and 29 (34%) still had APTM of undetermined etiology. Oligoclonal bands in CSF were more frequent in patients with MS (92%) than in patients with APTM of undetermined etiology (38%). Brain MRI results were abnormal in 87% of patients with MS and 27% of patients with APTM of undetermined etiology; visual evoked potentials were abnormal in 43% of patients with MS and 4% of patients with APTM of undetermined etiology. Oligoclonal bands in CSF (odds ratio, 15.76 [95% CI, 2.95-84.24]) and at least 1 MRI-detected brain lesion (odds ratio, 7.74 [95% CI, 2.42-24.74]) were independent predictive factors for conversion to MS.

CONCLUSION:

Our study confirms that abnormal brain MRI results and the presence of oligoclonal bands in CSF are 2 independent predictive factors for conversion to MS. No clinical, biological, or MRI factor at onset was predictive of long-term disability.

PMID:
22410443
DOI:
10.1001/archneurol.2011.949
[Indexed for MEDLINE]

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