title: Etiologic spectrum and functional outcome of the acute inflammatory myelitis.
abstract: Clinical, neuroimaging, and laboratory features are not specific enough to establish the etiological diagnosis of the acute inflammatory myelitis (AIM). Longitudinally extensive transverse myelitis (LETM) seen on magnetic resonance imaging (MRI) has been associated with a poor functional prognosis. The aim of this study was to assess the functional outcomes of a first AIM event comparing patients with LETM vs. no LETM on MRI and to report the differential diagnosis. Clinical, radiological, biochemical aspects were collected, and Winner-Hughes Functional Disability Scale (WHFDS) was performed after 3 and 6 months. Centromedullary lesions were associated with LETM, lateral lesions with partial lesion (PL), and brain MRI lesions with multiple sclerosis and acute encephalomyelitis disseminated. LETM patients were associated with a worse functional outcome as the need of a wheelchair after 3 and 6 months (OR = 7.61 p = 0.01; OR 4.8 p = 0.04, respectively), a walker or cane (OR = 11.0 p = 0.002, OR = 4.3 p = 0.03, respectively). In addition, we found a correlation between LETM and acute complete transverse myelitis and PL with acute partial transverse myelitis (83.3 and 90.9%, respectively; p < 0.0001). In conclusion, AIM is a heterogeneous syndrome from an etiological point of view and LETM patients had worse functional prognosis compared with PL after 3 and 6 months.
authors.affiliation: Department of Neurology, Hospital Carlos G. Durand, University of Buenos Aires, Av Díaz Vélez 5044, Buenos Aires, Argentina. junior.carnero@hotmail.com.
authors.forename: Edgar
authors.initials: E
authors.lastname: Carnero Contentti
authors.affiliation: Department of Neurology, Hospital Carlos G. Durand, University of Buenos Aires, Av Díaz Vélez 5044, Buenos Aires, Argentina.
authors.forename: Javier Pablo
authors.initials: JP
authors.lastname: Hryb
authors.affiliation: Department of Neurology, Hospital Carlos G. Durand, University of Buenos Aires, Av Díaz Vélez 5044, Buenos Aires, Argentina.
authors.forename: Ana
authors.initials: A
authors.lastname: Diego
authors.affiliation: Department of Neurology, Hospital Carlos G. Durand, University of Buenos Aires, Av Díaz Vélez 5044, Buenos Aires, Argentina.
authors.forename: José Luis
authors.initials: JL
authors.lastname: Di Pace
authors.affiliation: Department of Neurology, Hospital Carlos G. Durand, University of Buenos Aires, Av Díaz Vélez 5044, Buenos Aires, Argentina.
authors.forename: Mónica
authors.initials: M
authors.lastname: Perassolo
mesh_terms: D000328:Adult; D000893:Anti-Inflammatory Agents / Q000494:pharmacology / Q000627:therapeutic use; D004679:Encephalomyelitis / Q000150:complications / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000639:trends*; D008297:Male; D008775:Methylprednisolone / Q000494:pharmacology / Q000627:therapeutic use; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications / Q000000981:diagnostic imaging; D009188:Myelitis, Transverse / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000209:etiology*; D009471:Neuromyelitis Optica / Q000150:complications / Q000000981:diagnostic imaging; D020127:Recovery of Function / Q000187:drug effects / Q000502:physiology*; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000893:Anti-Inflammatory Agents; D008775:Methylprednisolone
keywords: Longitudinally extensive transverse myelitis; Multiple sclerosis; Neuromyelitis optica; Partial myelitis; Prognosis; South America