Transverse myelitis. Retrospective analysis of 33 cases, with differentiation of cases associated with multiple sclerosis and parainfectious events
D. R. Jeffery, R. N. Mandler and L. E. Davis
Spinal Cord Injury Service, Veterans Affairs Medical Center, Albuquerque, NM 87108.
OBJECTIVE--A study was undertaken to determine whether cases of
parainfectious-associated transverse myelitis (TM) and multiple
sclerosis-associated TM could be distinguished on the basis of clinical
criteria, radiologic features, or cerebrospinal fluid examination. A
secondary objective was to determine the incidence of TM in a US
population. DESIGN--A retrospective analysis of 33 cases was conducted.
Cases were classified as being related to parainfectious multiple
sclerosis, or spinal cord ischemia, or idiopathic. SETTING--All cases
occurring in the Albuquerque, NM, area from 1960 through 1990 were
reviewed. The population base was 500,000. OUTCOME MEASURES--Clinical
presentation, radiologic features, cerebrospinal fluid, recovery of
ambulation and bladder function, and recurrence rates were compared.
RESULTS--Thirty-three patients satisfied study criteria, corresponding to
an incidence of 4.6 per million per year. Forty-five percent of these cases
were categorized as parainfectious, 21% as associated with multiple
sclerosis, 12% as associated with spinal cord ischemia, and 21% as
idiopathic. Patients with parainfectious TM suffered from spinal shock more
frequently than did those with multiple sclerosis-associated TM. Patients
with parainfectious TM showed evidence of spinal cord swelling, whereas
patients with multiple sclerosis-associated TM had spinal cord plaques on
magnetic resonance images but none showed swelling. Oligoclonal bands were
absent in patients with parainfectious TM and present in three of five
patients with multiple sclerosis-associated TM. CONCLUSIONS--Parainfectious
TM may be distinguishable from that associated with multiple sclerosis on
the basis of presentation, findings on imaging, and the presence of
cerebrospinal fluid oligoclonal bands.
The long (-itudinally extensive) and the short of it: Transverse myelitis in children
Banwell
Neurology 2007;68:1447-1449.
FULL TEXT
Acute transverse myelitis in childhood: Center-based analysis of 47 cases
Pidcock et al.
Neurology 2007;68:1474-1480.
ABSTRACT
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Idiopathic Transverse Myelitis
Krishnan and Kerr
Arch Neurol 2005;62:1011-1013.
FULL TEXT
Clinical characteristics of African Americans vs Caucasian Americans with multiple sclerosis
Cree et al.
Neurology 2004;63:2039-2045.
ABSTRACT
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Idiopathic Recurrent Transverse Myelitis
Kim
Arch Neurol 2003;60:1290-1294.
ABSTRACT
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Acute Transverse Myelitis in Children: Clinical Course and Prognostic Factors
Defresne et al.
J Child Neurol 2003;18:401-406.
ABSTRACT
Proposed diagnostic criteria and nosology of acute transverse myelitis
Transverse Myelitis Consortium Working Group*
Neurology 2002;59:499-505.
ABSTRACT
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Bladder dysfunction in acute transverse myelitis: magnetic resonance imaging and neurophysiological and urodynamic correlations
Kalita et al.
J. Neurol. Neurosurg. Psychiatry 2002;73:154-159.
ABSTRACT
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Efficacy of high dose steroid therapy in children with severe acute transverse myelitis
Defresne et al.
J. Neurol. Neurosurg. Psychiatry 2001;71:272-274.
ABSTRACT
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Acute myelopathies: Clinical, laboratory and outcome profiles in 79 cases
de Seze et al.
Brain 2001;124:1509-1521.
ABSTRACT
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Spinal Cord Mass and Deferral of Biopsy: A Therapeutic Dilemma
Sheth and Jaynes
J Child Neurol 1998;13:237-238.
Case 8-1998- A 41-Year-Old Man with Leg Weakness and Mediastinal Lymphadenopathy
Querfurth and Mark
NEJM 1998;338:747-754.
FULL TEXT
Immune-Complex Allergic Vasculitis in Association with the Immune-Complex Allergic Vasculitis in Association with the Development of Transverse Myelitis: A Case Report
Nikol et al.
ANGIOLOGY 1996;47:1107-1110.
ABSTRACT
