Idiopathic Transverse Myelitis: An Experience in A Tertiary Care Setup

Abstract

Objective:

To observe the clinical, laboratory and radiological features of idiopathic transverse myelitis in patients presenting to the Department of Neurology Civil Hospital Karachi, and to assess the outcome in terms of  clinical recovery at four weeks.
Methodology:

A prospective observational study in which patients were identified according to a Performa developed on the basis of diagnostic criteria provided by Transverse Myelitis Consortium Working Group. 1 Patients presenting with acute myelopathy other than Idiopathic transverse myelitis were excluded clinically and radiologically on the basis of same diagnostic criteria. 

Results:

Seventy two patients, 58.3% males and 41.6% females with a mean age of 28 years were identified as idiopathic transverse myelitis over a period of seven years, from July 2003- June 2010. Weakness of limbs was the commonest first symptom at onset, occurring in 27(37.5%) patients and duration of onset from the beginning of symptoms to completed weakness ranged from 10 hours (< 1day) to 28 days, with a mean of 5.04 days. Paraplegia was commoner than quadriplegia occurring in 69.4% of patients. Four (5.5%) patients had no imaging abnormalities. 
Conclusion:

Idiopathic transverse myelitis is not an uncommon disease in our population. It did not behave very differently from what is reported in the international literature, with myelitis most commonly involving the dorsal spine, spanning over more than two spinal segments and showing complete or partial recovery in majority of cases with timely presentation for treatment