Functional recovery of chronic complete idiopathic transverse myelitis after administration of neurotrophic factors.
METHODS
Case report.


OBJECTIVE
To evaluate the functional recovery of chronic complete idiopathic transverse myelitis (ITM) after administration of acidic fibroblast growth factor (aFGF).


METHODS
A 28-year-old woman presented with a 4-year history of spastic paralysis, sensory level at T10, urinary retention and constipation due to ITM. In all, 20 microg aFGF bolus injection was applied via intradural lumbar puncture, which was repeated every 5 months for 15 months.


RESULTS
At 3 weeks after first injection, the patient experienced vague sensation at approximately T12-L1 dermatomes. At 2 months after the second injection, muscle activities and gait pattern were recorded in bilateral gluteus and hip abductors as she ambulated with long leg brace and axillary crutches. Increased walking speeds, reduced pelvic tilting and reduced compensatory trunk rotation during the swing phase were also demonstrated as compared to the initial gait analysis. At 18 months after injection, motor evoked potentials were obtained in hip abductors of both legs.


CONCLUSIONS
aFGF may increase the efficacy of spinal reactivation/regeneration and is a potential remedy for chronic transverse myelitis.
Lin
P-H
PH
Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital and National Yang-Ming University, Taiwan.
Chuang
T-Y
TY
Liao
K-K
KK
Cheng
H
H
Shih
Y-S
YS
D000328:Adult; D004334:Drug Administration Schedule; D019054:Evoked Potentials, Motor / Q000187:drug effects / Q000502:physiology; D005073:Evoked Potentials, Somatosensory / Q000187:drug effects / Q000502:physiology; D005260:Female; D016220:Fibroblast Growth Factor 1 / Q000008:administration & dosage*; D020233:Gait Disorders, Neurologic / Q000188:drug therapy / Q000209:etiology; D006801:Humans; D007278:Injections, Spinal; D009188:Myelitis, Transverse / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D009414:Nerve Growth Factors / Q000008:administration & dosage*; D009416:Nerve Regeneration / Q000187:drug effects / Q000502:physiology; D010264:Paraplegia / Q000188:drug therapy / Q000209:etiology; D010809:Physical Fitness / Q000502:physiology; D026741:Physical Therapy Modalities; D020127:Recovery of Function / Q000187:drug effects* / Q000502:physiology; D012678:Sensation Disorders / Q000188:drug therapy / Q000209:etiology; D013116:Spinal Cord / Q000187:drug effects* / Q000473:pathology / Q000503:physiopathology; D013129:Spinal Puncture; D016896:Treatment Outcome; D014555:Urination Disorders / Q000188:drug therapy / Q000209:etiology
D009414:Nerve Growth Factors; D016220:Fibroblast Growth Factor 1