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Early Response in Pediatric Transverse Myelitis: A Case-Control Study from Vietnam
Do Thanh Huong1,2, Ha Thi Lieu2, Dao Thi Nguyet1,2
1Department of Pediatrics, Hanoi Medical University, Hanoi, Vietnam.
Annals of Indian Academy of Neurology
|February 3, 2026
Summary
Severe motor and respiratory weakness at the start of treatment predict a poor early response in pediatric acute transverse myelitis (ATM). This finding aids in identifying children needing intensive management for better outcomes.
Area of Science:
- Pediatric Neurology
- Inflammatory Neurological Diseases
- Spinal Cord Disorders
Background:
- Acute transverse myelitis (ATM) is a rare inflammatory spinal cord disorder in children, causing significant dysfunction.
- Early treatment response data in pediatric ATM is limited, especially in Southeast Asia.
Purpose of the Study:
- To identify clinical, radiological, and immunological factors associated with early in-hospital treatment response in Vietnamese children with ATM.
Main Methods:
- Retrospective case-control study of 56 children diagnosed with ATM (2018-2023).
- Comparison of cases (poor early response) and controls (good early response) using the Paine and Byers scale.
- Analysis of clinical data, CSF, MRI findings, and MOG/AQP4 antibody status; logistic regression used.
Main Results:
- Severe lower limb motor weakness (MRC scale ≤ 1) at admission was independently associated with poor early response (OR 14.7).
- Respiratory muscle weakness, mechanical ventilation need, and absence of MOG antibodies correlated with poor outcomes.
- Radiological features like LETM and cervical involvement were not significantly linked to early response.
Conclusions:
- Severe motor and respiratory impairment at presentation are key indicators of poor early treatment response in pediatric ATM.
- Prompt recognition of these factors can guide risk stratification and early management strategies.
- Further longitudinal studies are recommended to assess the predictive value for long-term recovery.
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