title: The Etiological Spectrum of Acute Sensory Myelitis.
abstract: OBJECTIVE
  Acute myelitis patients exhibiting only sensory deficits upon initial presentation are not commonly encountered in clinical practice, but they definitely exist. Since acute sensory myelitis has not been investigated previously, this study evaluated the etiological spectrum of the condition with the aim of describing the clinical characteristics thereof.
  
  
  METHODS
  Patients with acute myelitis who presented at the Ewha Womans University Medical Center (during 1999-2012) and the National Cancer Center (during 2005-2014) with only sensory symptoms as first clinical features were enrolled in this study. Their medical records, electrophysiological and laboratory data, and MRI findings were analyzed retrospectively.
  
  
  RESULTS
  Of a total of 341 acute myelitis patients, 52 (15%) were identified as having acute sensory myelitis. The male-to-female ratio of these patients was 35:17, and their age at the onset of the condition was 41.7±10.5 years (mean±SD; range, 24-72 years). Acute sensory myelitis developed in patients with multiple sclerosis (MS; 14%), neuromyelitis optica spectrum disorder (NMOSD; 17%), and acute myelitis associated with concurrent systemic diseases including Behçet's disease and cancer (6%). Despite detailed evaluation, the etiology of 33 patients with acute myelitis could not be determined. Longitudinally extensive transverse myelitis on spinal MRI and progression of the sensory level were observed most commonly in NMOSD patients (89% and 78%, respectively); however, these patients did not exhibit sensory dissociation. Residual negative sensory symptoms were observed more frequently in NMOSD patients (33%) than in those with acute myelitis of unknown cause (24%) or MS (14%). During the long-term follow-up (4.7±2.7 years) of patients who did not undergo maintenance immunotherapy, a monophasic clinical course was common in those with acute myelitis of unknown cause (76%), but not in NMOSD or MS patients.
  
  
  CONCLUSIONS
  Accurate identification of the diverse nature of acute sensory myelitis may assist in patient care.
authors.affiliation: Department of Neurology, Ewha Womans University Graduate School of Medicine, Seoul, Korea.; Department of Neurology, National Cancer Center, Goyang, Korea.
authors.forename: Jae Won
authors.initials: JW
authors.lastname: Hyun
authors.affiliation: Department of Neurology, Myongji Hospital, Goyang, Korea.
authors.forename: Jee Young
authors.initials: JY
authors.lastname: Kim
authors.affiliation: Department of Neurology, Ewha Womans University Graduate School of Medicine, Seoul, Korea.
authors.forename: Kyung Gyu
authors.initials: KG
authors.lastname: Choi
authors.affiliation: Department of Neurology, National Cancer Center, Goyang, Korea.
authors.forename: Ho Jin
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: Department of Neurology, Ewha Womans University Graduate School of Medicine, Seoul, Korea. pkd1165@ewha.ac.kr.
authors.forename: Kee Duk
authors.initials: KD
authors.lastname: Park
keywords: acute; etiology; myelitis; sensory