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Transverse myelitis. Comparison with spinal cord presentations of multiple sclerosis
T F Scott1, K Bhagavatula, P J Snyder
1Department of Neurology, Allegheny University of the Health Sciences, Pittsburgh, PA, USA.
Neurology
|March 4, 1998
Summary
Symmetry in motor and sensory deficits reliably distinguishes acute myelopathic multiple sclerosis (MMS) from acute transverse myelitis (ATM). ATM patients typically present with symmetric symptoms, while MMS patients exhibit asymmetry, aiding in early diagnosis.
Area of Science:
- Neurology
- Clinical Medicine
- Immunology
Background:
- Differentiating acute myelopathic multiple sclerosis (MMS) from acute transverse myelitis (ATM) is clinically significant.
- Understanding the distinct clinical presentations can improve diagnostic accuracy and patient management.
Purpose of the Study:
- To test the hypothesis that symptom symmetry at presentation can reliably distinguish between ATM and MMS.
- To delineate clinical and laboratory features differentiating these two myelopathic conditions.
Main Methods:
- Retrospective review of 20 ATM patients and 16 MMS patients.
- Analysis of motor and sensory impairment symmetry using discriminant function analysis.
- Application of established clinical criteria for ATM and Poser's criteria for MS.
Main Results:
- All ATM patients presented with symmetric motor and sensory deficits (p<0.001).
- MMS patients predominantly showed asymmetric motor or sensory symptoms (15/16 patients).
- No overlap was observed; MS patients did not meet ATM criteria, and ATM patients did not develop MS.
Conclusions:
- Symptom symmetry is a highly reliable differentiator between ATM and MMS.
- MMS can be readily distinguished from ATM based on the pattern of neurological deficits at onset.
- This finding supports distinct pathophysiological mechanisms and aids in early diagnosis.