Document Detail


Long-term follow-up of acute partial transverse myelitis.
MedLine Citation:
PMID:  22410443     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Bertrand Bourre; Hélène Zéphir; Jean-Claude Ongagna; Charlotte Cordonnier; Nicolas Collongues; Stephanie Debette; Marie-Celine Fleury; Olivier Outteryck; Olivier Outerryck; Didier Hannequin; Patrick Vermersch; Jerome de Seze
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Archives of neurology     Volume:  69     ISSN:  1538-3687     ISO Abbreviation:  Arch. Neurol.     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-03-13     Completed Date:  2012-05-01     Revised Date:  2013-01-31    
Medline Journal Info:
Nlm Unique ID:  0372436     Medline TA:  Arch Neurol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  357-62     Citation Subset:  AIM; IM    
Affiliation:
Service de Neurologie, Hôpital Charles Nicolle, 1 rue de Germont, Rouen Cedex, France. bertrandbourre@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Brain / pathology
Disability Evaluation
Disease Progression
Evoked Potentials, Visual / physiology
Female
Follow-Up Studies
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Multiple Sclerosis / cerebrospinal fluid,  pathology
Myelitis, Transverse / cerebrospinal fluid,  pathology*
Neurologic Examination
Predictive Value of Tests
Prognosis
Prospective Studies
Risk
Spinal Cord / pathology
Spinal Puncture
Young Adult
Comments/Corrections
Comment In:
Arch Neurol. 2012 Nov;69(11):1523; author reply 1523-4   [PMID:  23117920 ]
Erratum In:
Arch Neurol. 2012 Jun;69(6):789
Note: Outerryck, Olivier [corrected to Outteryck, Olivier]

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