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Acute transverse myelitis in demyelinating diseases among the Chinese

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Abstract

The aim of the study was to characterize the demographic, clinical, and prognostic features of Chinese patients with acute transverse myelitis (ATM). The clinical data from ATM patients in a demyelinating disease database were analyzed retrospectively. Sixty-seven ATM patients with a follow-up duration longer than 2 years were identified. The frequency of neuromyelitis optica-related ATM (NMO-ATM) was high in our cohort (40.3%). Recurrent ATM (R-ATM), with a female predominance, was common in total idiopathic ATM (69.0%, 20/29). In R-ATM with longitudinally extensive spinal cord lesions (LESCLs), the high seropositivity of NMO-IgG, spinal cord lesions mostly involved the central gray matter and severer long-term disability were similar to NMO-ATM. In RTM without LESCLs, low seropositivity of NMO-IgG, preferentially involvement of the peripheral white matter and relative better neurological recovery were consistent with multiple sclerosis-related ATM (MS-ATM). The transition rates to MS in patients with acute partial transverse myelitis (APTM) and acute complete transverse myelitis (ACTM) were not significant (16.7 vs. 6.3%, P = 0.753), while LESCLs (OR = 11.4, P = 0.028) were significantly correlated with transition to NMO. The presence of LESCLs was the only variable showing a higher risk for reaching Rankin 3 (hazard ratio: 2.5, 95% CI: 1.0–6.1). Chinese patients with ATM had demographic, clinical, and prognostic features different from those in Western populations. Idiopathic R-ATM, common in Chinese, is a heterogeneous entity that shares partial clinical, spinal MRI and prognostic features with MS-ATM and NMO-ATM. The length of spinal cord lesion, rather than APTM/ACTM, may be a prognostic factor associated with clinical outcome and long-term disability in our population.

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Acknowledgments

The study was supported by Technology Project of Guangzhou City (No. 2060402).

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Authors and Affiliations

  1. Multiple Sclerosis Center, Department of Neurology, The Third Affiliated Hospital of Sun Yat-Sen University, No. 600 Tianhe Road, Guangzhou, 510630, Guangdong, China

    R. Li, W. Qiu, Z. Lu, Y. Dai, A. Wu, Y. Long, Y. Wang, J. Bao & X. Hu

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  1. R. Li
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  2. W. Qiu
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  3. Z. Lu
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  9. X. Hu
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Correspondence to X. Hu.

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R. Li and W. Qiu contributed equally to this work.

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Li, R., Qiu, W., Lu, Z. et al. Acute transverse myelitis in demyelinating diseases among the Chinese. J Neurol 258, 2206–2213 (2011). https://doi.org/10.1007/s00415-011-6093-y

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  • DOI: https://doi.org/10.1007/s00415-011-6093-y

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