title: Differential diagnosis and prognosis for longitudinally extensive myelitis in Buenos Aires, Argentina.
abstract: BACKGROUND
  Longitudinally extensive myelitis (LETM) has classically been grouped with the full or limited neuromyelitis optica spectrum disorders (NMOSD). However, differential diagnosis reveals a wide range of aetiologies.
  
  
  OBJECTIVE
  To report on differential diagnosis and prognosis for LETM observed in a group of patients in Buenos Aires, Argentina.
  
  
  METHODS
  Cross-sectional and retrospective multicentre study in two hospitals in Buenos Aires from June 2008 to June 2014.
  
  
  METHODS
  medullary syndrome associated with spinal cord lesion extending for 3 or more contiguous spinal segments in magnetic resonance imaging (MRI). Clinical, radiological, and biochemical data were collected and subjects were rated on the Hughes functional disability scale (WHFDS) at 3 months.
  
  
  RESULTS
  We evaluated 27 patients, 74% of whom were women; mean age was 35.22 years. The NMO-IgG antibody test was performed in 66.6% and oligoclonal band testing in 71%. NMO-IgG seropositivity was found exclusively in NMOSD patients (75%). Brain MRI was normal in 59.2% and revealed a mean of 7.9 affected spinal segments. Differential diagnoses revealed NMOSD (37%), idiopathic LETM (22.2%), lupus (11.1%), tumour (11.1%), dural fistula (7.4%), acute disseminated encephalomyelitis (7.4%), and a single case of multiple sclerosis (3.7%). Patients with lesions to ≥ 7 spinal segments showed poor recovery at 3 months (P<.001); these cases were associated with neoplastic, vascular, idiopathic, and lupus-related aetiologies.
  
  
  CONCLUSIONS
  The most frequent causes of LETM in our cohort were NMOSD followed by idiopathic cases. Neoplastic, vascular, lupus-related, and idiopathic LETM may constitute a critical group with a distinct prognosis and other treatment needs.
authors.affiliation: Consultorio de Neuroinmunología, Servicio de Neurología, Hospital Dr. Carlos G. Durand, Ciudad Autónoma de Buenos Aires, Argentina. Electronic address: junior.carnero@hotmail.com.
authors.forename: E
authors.initials: E
authors.lastname: Carnero Contentti
authors.affiliation: Consultorio de Neuroinmunología, Servicio de Neurología, Hospital Dr. Carlos G. Durand, Ciudad Autónoma de Buenos Aires, Argentina.
authors.forename: J P
authors.initials: JP
authors.lastname: Hryb
authors.affiliation: Servicio de Neurología, Hospital General de Agudos Dr. Teodoro Álvarez, Ciudad Autónoma de Buenos Aires, Argentina.
authors.forename: F
authors.initials: F
authors.lastname: Leguizamón
authors.affiliation: Consultorio de Neuroinmunología, Servicio de Neurología, Hospital Dr. Carlos G. Durand, Ciudad Autónoma de Buenos Aires, Argentina.
authors.forename: J L
authors.initials: JL
authors.lastname: Di Pace
authors.affiliation: Servicio de Neurología, Hospital General de Agudos Dr. Teodoro Álvarez, Ciudad Autónoma de Buenos Aires, Argentina.
authors.forename: J
authors.initials: J
authors.lastname: Celso
authors.affiliation: Servicio de Neurología, Hospital General de Agudos Dr. Teodoro Álvarez, Ciudad Autónoma de Buenos Aires, Argentina.
authors.forename: E
authors.initials: E
authors.lastname: Knorre
authors.affiliation: Consultorio de Neuroinmunología, Servicio de Neurología, Hospital Dr. Carlos G. Durand, Ciudad Autónoma de Buenos Aires, Argentina.
authors.forename: M B
authors.initials: MB
authors.lastname: Perassolo
mesh_terms: D000328:Adult; D001118:Argentina; D003430:Cross-Sectional Studies; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009188:Myelitis, Transverse / Q000175:diagnosis*; D009471:Neuromyelitis Optica / Q000175:diagnosis* / Q000000981:diagnostic imaging; D011379:Prognosis; D012189:Retrospective Studies; D013116:Spinal Cord / Q000473:pathology
keywords: Anticuerpo antiaquaporina-4; Aquoporin-4 antibody; Diagnósticos diferenciales; Differential diagnosis; Longitudinally extensive transverse myelitis; Mielitis transversa longitudinal extensa; Neuromielitis óptica; Neuromyelitis optica; Prognosis; Pronóstico