title: Partial acute transverse myelitis is a predictor of multiple sclerosis in children.
abstract: BACKGROUND
  Acute transverse myelitis (ATM) in children is a rare and often severe disease for which there are few known prognostic factors, particularly the subsequent risk of multiple sclerosis (MS) diagnosis.
  
  
  OBJECTIVE
  To determine the clinical course and prognostic factors after a first episode of ATM in children.
  
  
  METHODS
  Thirty children below 16 years of age diagnosed with a first neurological episode of ATM were included retrospectively. Clinical evaluation, treatment, laboratory, and MRI data were collected.
  
  
  RESULTS
  Median age at onset was 11 years (range 3-15 years). Follow-up data were available for a median of 4 years (range 0.5-16.7 years). Five patients subsequently had a diagnosis of MS (17%), which was associated with acute partial transverse myelitis (odds ratio 5; 95% confidence interval 2.3-11), with a 60% probability of having a relapse at five years (p < 0.01). The 2011 Verhey criteria correctly identified MS in children with the highest specificity (96%) and sensitivity (80%).
  
  
  CONCLUSIONS
  Acute partial transverse myelitis and brain MRI abnormalities at initial presentation are significantly predictive of a subsequent diagnosis of MS in children with ATM. These findings suggest that closer brain MRI monitoring after acute partial transverse myelitis might make the earlier introduction of disease-modifying therapies possible.
authors.affiliation: CHRU Montpellier, Neuropédiatrie, France INSERM U1046, Université Montpellier 1, Université Montpellier 2, France p-meyer@chu-montpellier.fr.
authors.forename: P
authors.initials: P
authors.lastname: Meyer
authors.affiliation: CHRU Montpellier, Neuroradiologie, France.
authors.forename: N
authors.initials: N
authors.lastname: Leboucq
authors.affiliation: CHRU Montpellier, Service DIM, Université Montpellier 1, UMR 729 MISTEA, France.
authors.forename: N
authors.initials: N
authors.lastname: Molinari
authors.affiliation: CHRU Montpellier, Neuropédiatrie, France INSERM U1051, Institut de Neurosciences de Montpellier, Université Montpellier 1, Université Montpellier 2, France.
authors.forename: A
authors.initials: A
authors.lastname: Roubertie
authors.affiliation: CHRU Montpellier, Neuropédiatrie, France.
authors.forename: M
authors.initials: M
authors.lastname: Carneiro
authors.affiliation: CHRU Montpellier, Neuropédiatrie, France.
authors.forename: U
authors.initials: U
authors.lastname: Walther-Louvier
authors.affiliation: CHRU Montpellier, Neuropédiatrie, France CHRU Montpellier, Neurophysiologie Clinique, France.
authors.forename: D
authors.initials: D
authors.lastname: Cuntz-Shadfar
authors.affiliation: CHRU Montpellier, Neuropédiatrie, France.
authors.forename: J
authors.initials: J
authors.lastname: Leydet
authors.affiliation: CHRU Montpellier, Neuropédiatrie, France.
authors.forename: R
authors.initials: R
authors.lastname: Cheminal
authors.affiliation: CHRU Montpellier, Réanimation Pédiatrique, France.
authors.forename: G
authors.initials: G
authors.lastname: Cambonie
authors.affiliation: CHRU Montpellier, Neuropédiatrie, France.
authors.forename: B
authors.initials: B
authors.lastname: Echenne
authors.affiliation: CHRU Montpellier, Neurophysiologie Clinique, France.
authors.forename: G
authors.initials: G
authors.lastname: Rondouin
authors.affiliation: AP-HP, CHU Bicêtre, Neuropédiatrie, Le Kremlin-Bicêtre, France National Referral Center for Neuro-Inflammatory Diseases in Children, Le Kremlin-Bicêtre, France.
authors.forename: K
authors.initials: K
authors.lastname: Deiva
authors.affiliation: AP-HP, CHU Bicêtre, Unité de Rééducation Neurologique Infantile, Le Kremlin Bicêtre, France INSERM U669, Université Paris Sud11, France.
authors.forename: Y
authors.initials: Y
authors.lastname: Mikaeloff
authors.affiliation: CHRU Montpellier, Neuropédiatrie, France INSERM U1046, Université Montpellier 1, Université Montpellier 2, France.
authors.forename: F
authors.initials: F
authors.lastname: Rivier
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D017668:Age of Onset; D001921:Brain / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D009103:Multiple Sclerosis / Q000150:complications / Q000175:diagnosis*; D009188:Myelitis, Transverse / Q000175:diagnosis* / Q000209:etiology; D011379:Prognosis; D012189:Retrospective Studies; D012306:Risk; D013116:Spinal Cord / Q000473:pathology*
keywords: Multiple sclerosis; acute transverse myelitis; magnetic resonance imaging; pediatric