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Acute partial transverse myelitis: risk factors for conversion to multiple sclerosis

J Sellner1, N Lüthi, R Bühler

  • 1Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland [corrected] sellner@lrz.tum.de

European Journal of Neurology
|March 4, 2008
PubMed

Insights

Predicting multiple sclerosis (MS) conversion from acute partial transverse myelitis (APTM) is crucial. Family history, high disability scores, brain MRI lesions, and CSF abnormalities indicate increased MS risk in APTM patients.

Area of Science:

  • Neurology
  • Neuroimmunology
  • Clinical Neuroscience

Background:

  • Acute partial transverse myelitis (APTM) can be an initial symptom of multiple sclerosis (MS) or a standalone condition.
  • Identifying predictors for relapse or MS conversion is vital for patient management and prognosis.

Purpose of the Study:

  • To determine clinical, laboratory, and neuroimaging factors that predict relapse or conversion to MS in patients experiencing their first APTM episode.

Main Methods:

  • A retrospective analysis of 73 patients with first-ever APTM was conducted.
  • Data collected included demographics, clinical status, cerebrospinal fluid (CSF) analysis, brain magnetic resonance imaging (MRI), and evoked potentials.
  • Follow-up ranged from 12 to 90 months to assess outcomes like monophasic event, MS conversion, or relapsing myelitis.

Main Results:

  • APTM was monophasic in 47.9%, converted to MS in 43.8%, and recurred as relapsing myelitis in 8.2% of patients.
  • Univariate analysis identified family history of MS, higher Expanded Disability Status Scale (EDSS) at onset, and brain MRI lesions as predictors of MS conversion.
  • CSF-specific oligoclonal bands and abnormal IgG index were also associated with an increased risk of developing MS.

Conclusions:

  • Family history of MS, high EDSS at presentation, brain MRI lesions, and specific CSF abnormalities (oligoclonal bands, abnormal IgG index) are significant indicators of increased risk for MS conversion following a first APTM episode.

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