Brain, Vol 120, Issue 7 1115-1122, Copyright © 1997 by Oxford University Press
SM al Deeb, BA Yaqub, GW Bruyn and NM Biary
We analysed the clinical, imaging, electrophysiological, laboratory
findings, course and prognostic factors in 31 patients with acute
transverse myelitis (20 men and 11 women; mean age, 30 years; range, 18- 51
years). All patients were assessed for maximal clinical deficit 'deficit
score'; pattern-shift visual, auditory and somatosensory evoked potentials
were measured, CSF was examined, and neuroimaging of the spinal cord and
brain (MRI or CT myelography) was carried out. The myelitis was preceded by
febrile illness in 25 (81%) of the patients. The site of the lesion was
cervical in 11 (36%), upper thoracic in two (6%), lower thoracic in 16
(52%). MRI of the spinal cord was abnormal in 10 out of the 20 patients
examined (50%); in the remaining 11 patients, only CT was carried out and
it was normal in all of them. Somatosensory evoked potentials were abnormal
in 19 (61%), while pattern-shift visual and brainstem auditory evoked
potentials were normal in all patients. CSF was abnormal in 94% of patients
with pleocytosis, increased protein or both. Eighteen patients (58%) had
good outcome. All patients had monophasic illness. Three variables have
emerged as being associated with significant worsening of the outcome: (i)
abnormal somatosensory evoked potentials; (ii) abnormal imaging and (iii)
high 'deficit score' at onset. Acute transverse myelitis affects a complete
segment of the spinal cord, is monophasic and represents a localized form
of postinfectious acute encephalomyelitis.
ARTICLES
Acute transverse myelitis. A localized form of postinfectious encephalomyelitis
Department of Clinical Neurosciences, Riyadh Armed Forces Hospital, Saudi Arabia.
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