Prognostic Indicators of Acute Transverse Myelitis in 39 Children

Abstract Background The Transverse Myelitis Consortium Working Group has proposed new diagnostic criteria for acute transverse myelitis. The purpose of the present study is to evaluate the relations between clinical variables and functional prognosis using new criteria. Methods We reviewed 39 Chines...

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Bibliographic Details
Published in:Pediatric neurology 2013-12, Vol.49 (6), p.397-400
Main Authors: Chen, Long, MD, Li, Jie, MD, Guo, Zhichao, MD, Liao, Shuang, MD, Jiang, Li, PhD MD
Format: Article
Language:English
Subjects:
Activities of Daily Living
acute transverse myelitis
Child
Child, Preschool
children
China
Disease Progression
Female
Follow-Up Studies
Humans
Male
Modified Barthel Index
Myelitis, Transverse - diagnosis
Myelitis, Transverse - physiopathology
Neurology
Pediatrics
Prognosis
prognostic marker
Statistics, Nonparametric
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Summary:Abstract Background The Transverse Myelitis Consortium Working Group has proposed new diagnostic criteria for acute transverse myelitis. The purpose of the present study is to evaluate the relations between clinical variables and functional prognosis using new criteria. Methods We reviewed 39 Chinese cases meeting the new criteria, recorded clinical epidemiological data, and followed activities of daily living measuring scale (Modified Barthel Index). Results Thirty-nine children met new criteria for definite acute transverse myelitis in the past 14 years between 1995 and 2008. Mean follow-up time was 102.7 months. Conversion to multiple sclerosis occurred in two patients (5.1%). Those children with a short time to maximal deficits, long time of peak neurological impairment and initial time of treatment, increased protein levels of the cerebrospinal fluid, and secondary infection were more likely to have residual neurological deficits, resulting in lower qualities of life ( P  = 0.005, P  = 0.003, P  = 0.011, P  = 0.0012, P  = 0.000, respectively). Conclusions A short time to maximal deficits, long time of peak neurological impairment and initial time of treatment, increased protein levels of cerebrospinal fluid, and secondary infection played important roles in predicting poor prognosis.
ISSN:0887-8994
1873-5150
DOI:10.1016/j.pediatrneurol.2013.08.022