Abstract
BackgroundIn 2002, the Transverse Myelitis Consortium Working Group (TMCWG) proposed the diagnostic criteria for idiopathic acute transverse myelitis (IATM) to delimit and unify this group of patients. This study aimed to describe the conversion rate to multiple sclerosis (MS) and variables associated with conversion, and to analyze functional outcome and prognostic factors associated with functional recovery in patients who fulfilled the current TMCWG criteria for definite and possible IATM.MethodsEighty-seven patients diagnosed with IATM between 1989 and 2011 were retrospectively reviewed. Two patients with positive neuromyelitis optica IgG serum antibodies were excluded. Epidemiological, clinical, laboratory, magnetic resonance imaging (MRI) data and outcome of 85 patients were analyzed.ResultsEleven (13%) patients converted to MS after a median follow-up of 2.9 years (interquartile range 1.0-4.8). Early-age onset of symptoms was related to conversion to MS. Only 9.4% of patients with IATM were unable to walk unassisted at the end of follow-up. Urinary sphincter dysfunction (odds ratio [OR] 3.37, 95% confidence interval [CI] 1.04-10.92) and longitudinally extensive transverse myelitis (LETM) on MRI (OR 12.34, 95% CI 3.38-45.00) were associated with a poorer outcome (Rankin ≥ 2).ConclusionsAt least 13% of patients who fulfill the TMCWG criteria for definite and possible IATM will convert to MS. Functional recovery in IATM is poorer in patients with urinary sphincter dysfunction at admission or LETM on MRI.
Highlights
In 2002, the Transverse Myelitis Consortium Working Group (TMCWG) proposed the diagnostic criteria for idiopathic acute transverse myelitis (IATM) to delimit and unify this group of patients
Identification of new diagnostic biomarkers, such as neuromyelitis optica (NMO) IgG antibodies has contributed to differentiate new conditions from the idiopathic group of acute transverse myelitis [2]. Another distinctive group of patients with an IATM event meeting the TMCWG criteria are individuals who present with a first attack of multiple sclerosis (MS) in the setting of an initially normal brain magnetic resonance imaging (MRI) study
The aim of this study was 1) to describe the conversion rate to MS and identify variables associated with conversion, and 2) to analyze the functional outcome and prognostic factors associated with recovery in patients who fulfill the current TMCWG criteria for possible and definite IATM
Summary
In 2002, the Transverse Myelitis Consortium Working Group (TMCWG) proposed the diagnostic criteria for idiopathic acute transverse myelitis (IATM) to delimit and unify this group of patients. In 2002, the Transverse Myelitis Consortium Working Group (TMCWG) presented the proposed diagnostic criteria for idiopathic acute transverse myelitis (IATM) to delimit and unify this group of patients [1]. Identification of new diagnostic biomarkers, such as neuromyelitis optica (NMO) IgG antibodies has contributed to differentiate new conditions from the idiopathic group of acute transverse myelitis [2] Another distinctive group of patients with an IATM event meeting the TMCWG criteria are individuals who present with a first attack of multiple sclerosis (MS) in the setting of an initially normal brain magnetic resonance imaging (MRI) study. There is a need to identify this cohort of patients early in the course of the disease
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