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Medline ® Abstract for Reference 63

of 'Transverse myelitis'

Idiopathic acute transverse myelitis: a clinical study and prognostic markers in 45 cases.
Bruna J, Martínez-Yélamos S, Martínez-Yélamos A, Rubio F, Arbizu T
Mult Scler. 2006;12(2):169.
OBJECTIVE: The Transverse Myelitis Consortium Working Group has proposed new diagnostic criteria for idiopathic acute transverse myelitis (ATM). We reviewed patients admitted to our center diagnosed with myelitis with two objectives: (i) to evaluate the usefulness of these criteria in distinguishing between myelitis as the first episode of multiple sclerosis (MS) and idiopathic ATM; and (ii) to analyse the clinical and laboratory variables that may be used as functional prognostic markers.
METHODS: We selected patients who met the criteria. We recorded clinical epidemiological data, patients treated with methylprednisolone, maximal disability reached and disability at final follow-up. We also recorded cerebrospinal fluid (CSF) data and the number of levels affected in the spinal magnetic resonance imaging (MRI).
RESULTS: Twenty-four patients fulfilled the criteria for definite ATM and 21 for possible ATM. Five patients converted to MS. Mean follow-up time was 3.5 years. There was an association between younger patients and femalepatients with conversion to MS. The highest Rankin score reached and increased CSF glucose levels were associated with a poor outcome. In multivariate analysis, only the admission Rankin score was associated with outcome.
CONCLUSIONS: (i) About 10% of patients who met the criteria may convert to MS; and (ii) admission Rankin score was the only independent prognostic factor found.
Department of Neurology, Hospital Universitari de Bellvitge, Institut d'InvestigacióBiomèdica de Bellvitge, Universitat de Barcelona, Spain. 35078jbe@comb.es