Neurophysiological studies in acute transverse myelitis

Area of Science:

• Neuroscience
• Neurology
• Clinical Electrophysiology

Background:

• Acute transverse myelitis (ATM) is a neurological disorder affecting the spinal cord.
• Evaluating motor and sensory pathways is crucial for understanding ATM prognosis.
• Electromyography (EMG), motor evoked potentials (MEPs), and somatosensory evoked potentials (SEPs) are key electrophysiological tools.

Purpose of the Study:

• To systematically evaluate anterior horn cell, motor, and sensory pathways in ATM patients using EMG, MEPs, and SEPs.
• To correlate electrophysiological findings with clinical status and spinal MRI.
• To assess the recovery of neurological function over 3 months.

Main Methods:

• Prospective hospital-based study of 39 ATM patients.
• Serial electrophysiological assessments (EMG, MEPs, SEPs) at admission and 3 months.
• Clinical evaluation and spinal MRI in a subset of patients.

Main Results:

• Central motor conduction time to tibialis anterior (CMCT-TA) was abnormal in 90% of patients; tibial SEPs were abnormal in 77%.
• EMG showed denervation in 51% of patients.
• CMCT and SEPs correlated with muscle power, tone, reflexes, MRI changes, and patient outcomes.

Conclusions:

• Electrophysiological studies, particularly CMCT and SEPs, are valuable for assessing ATM severity and predicting outcomes.
• Findings suggest significant involvement of the dorsal spinal cord in ATM.
• MEPs were found to be more frequently abnormal than SEPs in this cohort.