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Prognostic Parameters of Acute Transverse Myelitis in Children
Esther Ganelin-Cohen1,2,3, Osnat Konen2,3, Yoram Nevo1,2
1Institute of Pediatric Neurology, 36739Schneider Children's Medical Center of Israel, Petach Tikva, Israel.
Journal of Child Neurology
|August 19, 2020
Summary
Pediatric acute transverse myelitis, a rare spinal cord disorder, often shows good outcomes in children. Key prognostic factors include cerebrospinal fluid pleocytosis and absence of tetraparesis.
Area of Science:
- Pediatric Neurology
- Neuroimmunology
- Radiology
Background:
- Acute transverse myelitis is a rare, disabling neurological disorder affecting the spinal cord.
- Limited data exists on the specific imaging features and prognostic indicators in pediatric cases.
Purpose of the Study:
- To characterize the clinical and magnetic resonance imaging (MRI) findings in pediatric idiopathic acute transverse myelitis.
- To identify clinical and imaging features that predict patient prognosis.
Main Methods:
- Retrospective review of a tertiary pediatric medical center database (2002-2017).
- Inclusion of patients under 18 with idiopathic acute transverse myelitis, excluding those with recurrent demyelinating events.
- Analysis of clinical, laboratory, MRI findings, and patient outcomes.
Main Results:
- 23 children (mean age 10 years) were included; mean follow-up was 6 years 10 months.
- Common MRI finding was cross-sectional spinal cord involvement (70%), predominantly in the thoracic region (74%), averaging 8 spinal segments.
- Good prognosis predictors included cerebrospinal fluid pleocytosis, absence of tetraparesis, and prolonged time to nadir.
Conclusions:
- Most children with acute transverse myelitis experience favorable outcomes.
- Prompt diagnosis and timely treatment are crucial for improving prognosis.
- Further research with larger cohorts is needed to validate the predictive value of imaging features.
