Determinants of prognosis of acute transverse myelitis in children.
BACKGROUND
Acute transverse myelitis (ATM) is a severe disorder; recovery requires several months and often leaves neurologic residua. To determine what features of patients with acute transverse myelitis significantly influence prognosis, the authors reviewed reports of ATM in Japanese children published in the last 15 years (from 1987 to 2001).


METHODS
The authors studied reports of 50 Japanese patients (17 boys, 26 girls, 7 children of unspecified sex; mean age +/- SD, 8.0 +/- 3.8 years). Acute-phase and demographic features including age, increased deep tendon reflexes, Babinski reflex, sex, preceding infection, decreased deep tendon reflexes, time course of peak neurologic impairment, treatment with prednisolone and/or high-dose methylprednisolone, and the day of illness when treatment was started were used as independent variables in a regression analysis. The dependent variable was long-term persistence of neurologic deficits.


RESULTS
Younger patients and those without increased deep tendon reflexes or a Babinski reflex were more likely to have residual neurologic deficits such as paraplegia or tetraplegia, sensory loss and sphincter disturbance. No relationship was seen between prognosis and sex, preceding infections, decreased deep tendon reflexes, time course of peak neurologic impairment, treatment with prednisolone or high-dose methylprednisolone, or timing of treatment initiation.


CONCLUSIONS
Age at onset and neurologic features were important for outcome prediction in ATM. Steroid therapy did not associate with better outcome.
Miyazawa
Reiko
R
Department of Pediatrics, Tone Central Hospital, Numata, Gunma University School of Medicine, Maebashi and Saku Central Hospital, Minamisaku, Nagano, Japan.
Ikeuchi
Yuka
Y
Tomomasa
Takeshi
T
Ushiku
Hideo
H
Ogawa
Tetsushi
T
Morikawa
Akihiro
A
D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D009188:Myelitis, Transverse / Q000503:physiopathology*; D011379:Prognosis; D012044:Regression Analysis