Document Detail


Acute transverse myelitis with normal brain MRI : long-term risk of MS.
MedLine Citation:
PMID:  18080852     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Jui Perumal; Rana Zabad; Christina Caon; Megan MacKenzie; Alexandros Tselis; Fen Bao; Zahid Latif; Imad Zak; Robert Lisak; Omar Khan
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2007-12-20
Journal Detail:
Title:  Journal of neurology     Volume:  255     ISSN:  0340-5354     ISO Abbreviation:  J. Neurol.     Publication Date:  2008 Jan 
Date Detail:
Created Date:  2008-01-25     Completed Date:  2008-05-14     Revised Date:  2010-03-23    
Medline Journal Info:
Nlm Unique ID:  0423161     Medline TA:  J Neurol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  89-93     Citation Subset:  IM    
Affiliation:
Multiple Sclerosis Center, Dept. of Neurology, Wayne State University School of Medicine, Detroit, MI, USA.
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MeSH Terms
Descriptor/Qualifier:
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:
0/Oligoclonal Bands

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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