Acta Scientific Neurology (ASNE) (ISSN: 2582-1121)

Research Article Volume 4 Issue 10

Study of the Clinical Profile, Management and Follow Up of Patients with Longitudinally Extensive Transverse Myelitis in a Tertiary Care Centre in India

Kumar Abhinav1*, Aldrin Anthony Dung Dung2, Suman Kushwaha3 and Monali Chaturvedi4

1Senior Resident, Institute of Human Behaviour and Allied Sciences (IHBAS), Department of Neurology, New Delhi, India
2Assistant Professor, Institute of Human Behaviour and Allied Sciences (IHBAS), Department of Neurology, New Delhi, India
3H.O.D and Professor, Institute of Human Behaviour and Allied Sciences (IHBAS), Department of Neurology, New Delhi, India
4Assistant Professor, Institute of Human Behaviour and Allied Sciences (IHBAS), Department of Neuroradiology, New Delhi, India

*Corresponding Author: Kumar Abhinav, Senior Resident, Institute of Human Behaviour and Allied Sciences (IHBAS), Department of Neurology, New Delhi, India.

Received: July 20, 2021; Published: September 21, 2021

Abstract

Objective: To evaluate the clinical profile, response to treatment of different etiologies and prognosis of patients of LETM in Indian population.

Patients and Method: A hospital based prospective study was conducted in Department of Neurology, IHBAS, New Delhi from January 2018 to June 2019.

Total of 40 patients of LETM were stidied in detail and followed up for 6 months.

Result: In our series, NMO was the most common diagnosis constituting 20% of patients. Other common diagnosis were Tubercular Myelitis (17.5%), ATM (Post viral)(17.5%). Most common symptoms were sensory abnormalities followed by bladder/bowel involvement and parapresis. Maximun patients had partial recovery at 6 months (47.5%).

Conclusion: LETM is a heterogeneous diaorder with multiple etiologies. NMO is most common etiology but doesn't constitute majority of patients. So LETM patients should be extensively evaluated to find the correct diagnosis as prognosis depends on that.

Keywords: Transverse Myelitis; LETM; Neuromyelitis Optica; Paraparesis

References

  1. Eckstein C., et al. “Differential diagnosis of longitudinally extensive transverse myelitis in adults”. The European Neurological Journal1 (2011): 27.
  2. Tartaglino LM., et al. “Multiple sclerosis in the spinal cord: MR appearance and correlation with clinical parameters”. Radiology3 (1995): 725-732.
  3. Weinshenker BG., et al. “Neuromyelitis optica IgG predicts relapse after longitudinally extensive transverse myelitis”. Annals of Neurology3 (2006): 566-569.
  4. Wingerchuk DM., et al. “Revised diagnostic criteria for neuromyelitis optica”. Neurology 66 (2006): 1485-1489.
  5. Lennon VA., et al. “A serum autoantibody marker of neuromyelitis optica: distinction from multiple sclerosis”. The Lancet9451 (2004): 2106-2112.
  6. Jarius S., et al. “Cerebrospinal fluid findings in aquaporin-4 antibody positive neuromyelitis optica: results from 211 lumbar punctures”. Journal of the Neurological Sciences 1-2 (2011): 82-90.
  7. Pittock SJ., et al. “Brain abnormalities in neuromyelitis optica”. Archives of Neurology 3 (2006): 390-396.
  8. Pittock SJ., et al. “Neuromyelitis optica brain lesions localized at sites of high aquaporin 4 expression”. Archives of Neurology7 (2006): 964-968.
  9. Wingerchuk DM. “Diagnosis and treatment of neuromyelitis optica”. The Neurologist1 (2007): 2-11.
  10. Cassinotto C., et al. “MRI of the spinal cord in neuromyelitis optica and recurrent longitudinal extensive myelitis”. Journal of Neuroradiology4 (2009): 199-205.
  11. McKeon A., et al. “Coexistence of myasthenia gravis and serological markers of neurological autoimmunity in neuromyelitis optica”. Muscle and Nerve1 (2009): 87-90.
  12. Tartaglino LM., et al. “Multiple sclerosis in the spinal cord: MR appearance and correlation with clinical parameters”. Radiology 3 (1995): 725-732.
  13. Qiu W., et al. “Longitudinally extensive myelopathy in Caucasians: a West Australian study of 26 cases from the Perth Demyelinating Diseases Database”. Journal of Neurology, Neurosurgery and Psychiatry2 (2010): 209-212.
  14. Banwell B., et al. “Neuromyelitis optica-IgG in childhood inflammatory demyelinating CNS disorders”. Neurology5 (2008): 344-352.
  15. Berger JR and Sabet A. “Infectious myelopathies”. InSeminars in neurology. Copyright© 2002 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.:+ 1 (212) 584-4662 22.2 (2002): 133-142.
  16. Sellner J., et al. “The clinical spectrum and immunobiology of parainfectious neuromyelitis optica (Devic) syndromes”. Journal of Autoimmunity4 (2010): 371-379.
  17. Umehara F., et al. “Abnormalities of spinal magnetic resonance images implicate clinical variability in human T-cell lymphotropic virus type I–associated myelopathy”. Journal of Neurovirology3 (2007): 260-267.
  18. Delgado SR., et al. “Human T-lymphotropic virus type I or II (HTLV-I/II) associated with recurrent longitudinally extensive transverse myelitis (LETM): two case reports”. Journal of Neurovirology3 (2010): 249-253.
  19. Meurs L., et al. “Acute transverse myelitis as a main manifestation of early stage II neuroborreliosis in two patients”. European Neurology3 (2004): 186.
  20. Chilver-Stainer L., et al. “Syphilitic myelitis: rare, nonspecific, but treatable”. Neurology7 (2009): 673-675.
  21. Kikuchi S., et al. “Subacute syphilitic meningomyelitis with characteristic spinal MRI findings”. Journal of Neurology1 (2003): 106-107.
  22. Saleem S., et al. “Spinal cord schistosomiasis: MR imaging appearance with surgical and pathologic correlation”. American Journal of Neuroradiology 7 (2005): 1646-1654.
  23. Flanagan EP., et al. “Paraneoplastic isolated myelopathy: clinical course and neuroimaging clues”. Neurology24 (2011): 2089-2095.
  24. Ducray F., et al. “Devic’s syndrome-like phenotype associated with thymoma and antiCV2/CRMP5 antibodies”. Journal of Neurology, Neurosurgery and Psychiatry 3 (2007): 325-327.
  25. Graus F., et al. “Recommended diagnostic criteria for paraneoplastic neurological syndromes”. Journal of Neurology, Neurosurgery and Psychiatry 8 (2004): 1135-1140.
  26. Pittock SJ and Lucchinetti CF. “Inflammatory transverse myelitis: evolving concepts”. Current Opinion in Neurology4 (2006): 362-368.
  27. Pittock SJ., et al. “Amphiphysin autoimmunity: paraneoplastic accompaniments”. Annals of Neurology1 (2005): 96-107.
  28. Pittock SJ., et al. “Glutamic acid decarboxylase autoimmunity with brainstem, extrapyramidal, and spinal cord dysfunction”. In Mayo Clinic Proceedings9 (2006): 1207-1214.
  29. Krampla W., et al. “Spinal cord lesions in patients with neuromyelitis optica: a retrospective long-term MRI follow-up study”. European Radiology10 (2009): 2535-2543.
  30. Misra UK., et al. “MRI and electrodiagnostic study”. Electroencephalography and Clinical Neurophysiology 43 (2003): 57-66.
  31. Jain RS., et al. “Longitudinally extensive transverse myelitis: a retrospective analysis of sixty-four patients at tertiary care center of North-West India”. Clinical Neurology and Neurosurgery 148 (2016): 5-12.
  32. Sepúlveda M., et al. “Analysis of prognostic factors associated with longitudinally extensive transverse myelitis”. Multiple Sclerosis Journal 6 (2013): 742-748.

Citation

Citation: Kumar Abhinav., et al. “Study of the Clinical Profile, Management and Follow Up of Patients with Longitudinally Extensive Transverse Myelitis in a Tertiary Care Centre in India". Acta Scientific Neurology 4.10 (2021): 04-12.

Copyright

Copyright: © 2021 Kumar Abhinav., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




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