title: Etiologic spectrum and prognosis of longitudinally extensive transverse myelopathies.
abstract: BACKGROUND
  Patients with a first episode of longitudinal extensive transverse myelopathy (LETM) were reviewed with two objectives: to evaluate the clinical spectrum of LETM and to analyze the related clinical and laboratory variables that can be used as functional prognostic markers.
  
  
  METHODS
  A retrospective review was conducted of clinical, radiologic and biochemical data of patients admitted for LETM between 1993 and 2011.
  
  
  RESULTS
  Our cohort included 72 patients [median age 41 years, interquartile range (IQR) 29-61.5]. Median follow-up was 34 months (IQR 17.2-63). The modified Rankin Scale (mRS) score was ≥2 at the end of follow-up in 72.2%. The final diagnosis was idiopathic LETM in 22 patients, multiple sclerosis in 18, parainfectious disease in 11, systemic disease in 9, spinal cord infarction and neuromyelitis optica spectrum disorders in 3 patients each, and acute demyelinating encephalomyelitis, dural fistula, and tumor-related LETM in 2 patients each. Unfavorable outcome was associated with mRS ≥2 at admission [odds ratio (OR) 1.39, 95% confidence interval (CI) 1.16-1.66] and older age (OR 1.06, 95% CI 1.01-1.11).
  
  
  CONCLUSIONS
  Idiopathic LETM was the most frequent diagnosis at the end of follow-up. Older age and clinically severe disease at onset were independent prognostic factors of poorer functional recovery.
authors.affiliation: Multiple Sclerosis Unit, Neurology Department, Hospital Universitari de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Spain.
authors.forename: Álvaro
authors.initials: Á
authors.lastname: Cobo-Calvo
authors.forename: Agustí
authors.initials: A
authors.lastname: Alentorn
authors.forename: M Alba
authors.initials: MA
authors.lastname: Mañé Martínez
authors.forename: Laura
authors.initials: L
authors.lastname: Bau
authors.forename: Elisabet
authors.initials: E
authors.lastname: Matas
authors.forename: Jordi
authors.initials: J
authors.lastname: Bruna
authors.forename: Lucía
authors.initials: L
authors.lastname: Romero-Pinel
authors.forename: Sergio
authors.initials: S
authors.lastname: Martínez-Yélamos
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009188:Myelitis, Transverse / Q000175:diagnosis* / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D011379:Prognosis; D020127:Recovery of Function; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013116:Spinal Cord / Q000473:pathology; D055815:Young Adult