title: Long-term follow-up of acute partial transverse myelitis.
abstract: BACKGROUND
  Acute partial transverse myelitis (APTM) may be the first clinical symptom of multiple sclerosis (MS) or may remain a monophasic event.
  
  
  OBJECTIVE
  To evaluate the risk of conversion to MS and long-term disability, and to determine prognosis factors for disability.
  
  
  METHODS
  We identified patients with no previous history of neurological disease who experienced APTM between January 1998 and December 2005 and were followed up at 3 university hospitals in France. Data on the patients' demographics and clinical states during follow-up, as well as data on cerebrospinal fluid (CSF) analysis, brain and spinal cord magnetic resonance imaging (MRI), and visual evoked potentials, were analyzed.
  
  
  METHODS
  Neurology departments of 3 university hospitals in Lille, Strasbourg, and Rouen, France, respectively.
  
  
  METHODS
  A total of 85 patients with no previous history of neurological disease who experienced APTM.
  
  
  RESULTS
  The mean (SD) follow-up period was 104.8 (29.8) months. There were 57 women (67%) and 28 men (33%), with a mean (SD) age at onset of 36.7 (11.7) years. At the end of follow-up, 53 patients (62%) were classified as having MS with a mean (SD) Expanded Disability Status Scale score of 2.6 (1.8), 1 patient (1%) was classified as having postinfectious myelitis, 1 (1%) as having neuromyelitis optica, 1 (1%) as having Sjögren syndrome, and 29 (34%) still had APTM of undetermined etiology. Oligoclonal bands in CSF were more frequent in patients with MS (92%) than in patients with APTM of undetermined etiology (38%). Brain MRI results were abnormal in 87% of patients with MS and 27% of patients with APTM of undetermined etiology; visual evoked potentials were abnormal in 43% of patients with MS and 4% of patients with APTM of undetermined etiology. Oligoclonal bands in CSF (odds ratio, 15.76 [95% CI, 2.95-84.24]) and at least 1 MRI-detected brain lesion (odds ratio, 7.74 [95% CI, 2.42-24.74]) were independent predictive factors for conversion to MS.
  
  
  CONCLUSIONS
  Our study confirms that abnormal brain MRI results and the presence of oligoclonal bands in CSF are 2 independent predictive factors for conversion to MS. No clinical, biological, or MRI factor at onset was predictive of long-term disability.
authors.affiliation: Service de Neurologie, Hôpital Charles Nicolle, 1 rue de Germont, Rouen Cedex, France. bertrandbourre@gmail.com
authors.forename: Bertrand
authors.initials: B
authors.lastname: Bourre
authors.forename: Hélène
authors.initials: H
authors.lastname: Zéphir
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Ongagna
authors.forename: Charlotte
authors.initials: C
authors.lastname: Cordonnier
authors.forename: Nicolas
authors.initials: N
authors.lastname: Collongues
authors.forename: Stephanie
authors.initials: S
authors.lastname: Debette
authors.forename: Marie-Celine
authors.initials: MC
authors.lastname: Fleury
authors.forename: Olivier
authors.initials: O
authors.lastname: Outteryck
authors.forename: Olivier
authors.initials: O
authors.lastname: Outerryck
authors.forename: Didier
authors.initials: D
authors.lastname: Hannequin
authors.forename: Patrick
authors.initials: P
authors.lastname: Vermersch
authors.forename: Jerome
authors.initials: J
authors.lastname: de Seze
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001921:Brain / Q000473:pathology; D004185:Disability Evaluation; D018450:Disease Progression; D005074:Evoked Potentials, Visual / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000134:cerebrospinal fluid / Q000473:pathology; D009188:Myelitis, Transverse / Q000134:cerebrospinal fluid / Q000473:pathology*; D009460:Neurologic Examination; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012306:Risk; D013116:Spinal Cord / Q000473:pathology; D013129:Spinal Puncture; D055815:Young Adult