Document Detail

Long-term outcome of acute and subacute myelopathies.
MedLine Citation:
PMID:  19252779     Owner:  NLM     Status:  MEDLINE    
We aimed to evaluate the long-term (>2 years) outcome of acute and subacute myelopathies (ASM). We systematically followed-up consecutive patients presenting with a first episode of ASM, defined by spinal cord symptoms with an onset <3 weeks and duration >or=48 h. Patients with compressive or traumatic spinal cord lesions are excluded from this report. Our cohort consisted of 170 patients (median age 39.0 years, median duration of follow-up 73.2 months). The death rate was 8.8%, Lipton and Teasdall's functional score was bad or fair in 38.2%, and 37.1% of the survivors who worked when the ASM occurred were unable to carry on with the same profession. Unfavorable functional outcome was more frequent when (1) symptoms were initially severe, (2) the lesion was located centrally on spinal cord MRI and (3) the etiology was neuromyelitis optica (NMO) or systemic disease (SD). In one-third of patients the etiology at the end of follow-up differed from the etiology suspected after the initial diagnostic workup. Over half of patients initially diagnosed with myelopathy of undetermined cause subsequently developed multiple sclerosis, NMO or SD. ASM is a severe condition with a bad or fair functional outcome and a major impact on professional activity in one-third of the patients. Central lesions on spinal cord MRI and etiologies such as NMO or SD are associated with a worse functional outcome. Finally, a long-term follow-up is important given the large number of causes that are identified at a distance from the initial event.
S Debette; J de Sèze; J-P Pruvo; H Zephir; F Pasquier; D Leys; P Vermersch
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Publication Detail:
Type:  Journal Article     Date:  2009-02-28
Journal Detail:
Title:  Journal of neurology     Volume:  256     ISSN:  1432-1459     ISO Abbreviation:  J. Neurol.     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-06-22     Completed Date:  2009-09-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0423161     Medline TA:  J Neurol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  980-8     Citation Subset:  IM    
Department of Neurology, University Hospital of Lille, Hôpital Roger Salengro, CHRU de Lille, 59037, Lille, France.
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MeSH Terms
Cohort Studies
Follow-Up Studies
Magnetic Resonance Imaging
Middle Aged
Multiple Sclerosis / complications
Neuromyelitis Optica / complications
Severity of Illness Index
Spinal Cord / pathology
Spinal Cord Diseases / etiology,  pathology,  therapy*
Time Factors
Treatment Outcome
Young Adult

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