Abstract
Study design
Multicenter retrospective study.
Objectives
The aim was to determine the frequency and magnetic resonance imaging (MRI) features of short-segment transverse myelitis (STM) in patients with neuromyelitis optica spectrum disorders (NMOSD) during a myelitis attack.
Setting
Latin American diagnostic centres (Neuroimmunology Unit). A multicenter study from Argentina, Brazil and Venezuela was performed.
Methods
Seventy-six patients with NMOSD were included. We analyzed 346 attacks and reviewed spinal cord MRIs performed within 30 days from spinal attack onset. Sagittal and axial characteristics on cervical and thoracic MRI (1.5 tesla) were observed. Demographics, clinical, serological, and disability data were collected.
Results
Among the 76 patients with NMOSD, isolated STM was observed in 8% (n = 6), multisegmental lesions (longitudinally extensive transverse myelitis (LETM) + STM) in 28% (n = 21; 13 had at least one STM), LETM in 42% (n = 32), and normal spinal MRI in 22% (n = 17). However, isolated STM was increased by 10% in patients with NMOSD with spinal lesions (6 out of 59) with mean attacks of 2.5 (±0.83) and last follow-up expanded disability status scale (EDSS) of 3.1 (±2.63). Positive aquaporin 4 antibodies (AQP4-ab) were found in 50%. Upper-cervical lesion was most frequently observed (5 out of 6). Myelitis was preceded by ON in all isolated patients with STM. Only one had a positive gadolinium lesion and none of these had asymptomatic spinal cord lesion.
Conclusion
Isolated STM does not exclude NMOSD diagnosis. Therefore, APQ4-ab testing could be useful during a myelitis attack with STM.
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Funding
This research received no specific grant from any funding agency in the public, commercial, or non-profit sectors.
Author contributions
ECC was responsible for conception and design, acquisition of data, analysis and interpretation of data, drafting the manuscript, revising it for intellectual content, and finally for the final approval of the completed manuscript. VDM was responsible for acquisition of data, drafting the manuscript, revising it for intellectual content, and finally for the final approval of the completed manuscript. ABA, CdAC , CLM, ISdC, EA, VT, EC, JLDP, JPH, CL, OM, MP, AS, and AC were responsible for acquisition of data, revising it for intellectual content, and finally for the final approval of the completed manuscript.
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Carnero Contentti, E., Daccach Marques, V., Soto de Castillo, I. et al. Short-segment transverse myelitis lesions in a cohort of Latin American patients with neuromyelitis optica spectrum disorders. Spinal Cord 56, 949–954 (2018). https://doi.org/10.1038/s41393-018-0143-6
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DOI: https://doi.org/10.1038/s41393-018-0143-6
