[Infectious myelopathies: clinical, serological, and prognostic patterns].
BACKGROUND
Serological confirmation of an infectious acute myelitis injury is difficult to confirm as it is sometimes due to a post-infectious etiology.


OBJECTIVE
The aim of this study was to define the clinical, biological and prognostic patterns of infectious myelitis.


METHODS
This retrospective study included 153 subjects hospitalized in the department of neurology between 1993 and 2002 for treatment of a noncompressive acute myelopathy. Biological confirmation of recent infection was obtained in 12 patients (8 p. 100).


RESULTS
An infectious syndrome, beginning prior to the neurological symptoms, was found in 67 percent of patients. The clinical symptoms were severe with loss of sensoromotor and sphincter functions and ascending spinal cord dysfunction (acute transverse myelopathy). Spinal cord MRI showed extended centromedullar high intensity signals with rapid and complete regression. CSF analysis cell count was above 30/mm3 with hyperproteinorachia, in 75 percent and 58 percent of patients respectively. CSF electrophoresis did not detect oligoclonal bands. Clinical outcome was good in all patients except one, however sphincter disorders recovered slowly.


CONCLUSIONS
Our study illustrates a stereotypical clinical, biological and prognostic pattern for infectious acute myelitis. These findings contribute significantly to therapeutic decision making and establishing prognosis at the initial phase of acute myelopathy.
Ramirez
C
C
Clinique Neurologique, Hôpital R. Salengro, CHRU, Lille.
de Seze
J
J
Delalande
S
S
Michelin
E
E
Ferriby
D
D
Al Khedr
A
A
Stojkovic
T
T
Destée
A
A
Vermersch
P
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009187:Myelitis / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy; D011379:Prognosis; D012189:Retrospective Studies