| Acute transverse myelitis with normal brain MRI : long-term risk of MS. | |
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MedLine Citation:
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PMID: 18080852 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To investigate the long-term risk of developing MS in patients presenting with acute transverse myelitis (ATM) and normal brain MRI scans at onset. METHODS: We studied 58 ATM patients with normal brain MRI at presentation for up to 5 years with serial neurologic and imaging studies. All patients underwent CSF analysis at onset which was defined positive if two or more IgG oligoclonal bands and/or elevated IgG index were present. Brain and spinal cord MRI scans were obtained every 6 months for the first 2 years, and annually thereafter unless the patient experienced a second neurologic attack different from the initial episode to confirm CDMS or there was demonstration of MRI lesions confirming dissemination in time and space to fulfill McDonald imaging criteria to diagnose MS. RESULTS: Seventeen of 58 (29%) patients developed MS of which 7 (41%) patients developed CDMS and 10 (59%) developed MS using McDonald Imaging Criteria. Mean time to CDMS by a second clinical attack was 11. 1 months compared to 19. 2 months by MRI lesions (P = 0. 03). None of the patients developed MS after 24 months of onset. All 17 patients who developed MS had positive CSF although 15 patients who had positive CSF did not develop MS during the 5 years of follow-up. CONCLUSIONS: The majority of patients with ATM and normal brain MRI do not develop MS after 5 years of follow-up confirming the relatively low risk compared to patients with abnormal brain MRI scans. CSF is helpful in distinguishing patients more likely to develop MS. Compared to clinical attacks, serial imaging may not lead to an earlier diagnosis in ATM patients with normal brain MRI. |
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Authors:
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Jui Perumal; Rana Zabad; Christina Caon; Megan MacKenzie; Alexandros Tselis; Fen Bao; Zahid Latif; Imad Zak; Robert Lisak; Omar Khan |
Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2007-12-20 |
Journal Detail:
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Title: Journal of neurology Volume: 255 ISSN: 0340-5354 ISO Abbreviation: J. Neurol. Publication Date: 2008 Jan |
Date Detail:
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Created Date: 2008-01-25 Completed Date: 2008-05-14 Revised Date: 2010-03-23 |
Medline Journal Info:
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Nlm Unique ID: 0423161 Medline TA: J Neurol Country: Germany |
Other Details:
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Languages: eng Pagination: 89-93 Citation Subset: IM |
Affiliation:
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Multiple Sclerosis Center, Dept. of Neurology, Wayne State University School of Medicine, Detroit, MI, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Brain / immunology, pathology*, physiopathology Comorbidity Disease Progression Female Humans Longitudinal Studies Magnetic Resonance Imaging Male Multiple Sclerosis / cerebrospinal fluid, epidemiology*, pathology* Myelitis, Transverse / cerebrospinal fluid, epidemiology*, pathology* Oligoclonal Bands / cerebrospinal fluid Predictive Value of Tests Prognosis Risk Factors Spinal Cord / immunology, pathology*, physiopathology Time Factors |
| Chemical | |
Reg. No./Substance:
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0/Oligoclonal Bands |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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