A Clinical Profile of Transverse Myelitis with Special Reference to Outcomes: A 5-Year Retrospective Study

Transverse myelitis (TM), a rare inflammatory condition affecting the spinal cord, presents with a rapid onset of bilateral motor and sensory symptoms with or without bladder/bowel and sexual dysfunction. Recent studies are attempting to identify its improvement, worsening, or conversion to multiple sclerosis, and the factors that determine these outcomes. The present study aims to assess the immediate and long-term outcomes of TM and to determine the factors associated with them.

The study involved a retrospective review of hospital records of 30 patients diagnosed with TM between 2018 and 2022, followed by a telephonic interview to assess their present outcomes.

Median age of the patients was 40 years [Interquartile range (IQR) = 30-48.5], with 53% males. About 76.7% had longitudinally extensive transverse myelitis (LETM). Onset was acute in 63.3%. Half (50%) of the patients had paraparesis. MRI spine showed involvement of the long segment in 65.5% and the short segment in 24.1%. At the end of treatment, 43.3% patients improved partially, and 16.7% improved completely. At follow-up, nearly 30% of the respondents reported complete recovery, while 8.3% reported worsening. One patient (3.33%), with an acute onset of TM, quadriparesis, bowel involvement, sexual dysfunction, and long spinal segment involvement, converted to multiple sclerosis at follow-up. 25% of patients with initial partial improvement showed complete improvement at follow-up.

Acute onset LETM cases can potentially convert to multiple sclerosis. Patients who show early improvement, whether partial or complete, have higher chances of complete recovery at follow-up.