PROGNOSTIC PREDICTORS OF ACUTE TRANSVERSE MYELITIS

Introduction - The role of clinical, MRI and neurophysiological parame ters in predicting the outcome of acute transverse myelitis (ATM) is r eported. Materials and methods - Thirty-one patients with ATM were sub jected to clinical, MRI, somatosensory and motor evoked potential stud ies in both upper and lower limbs and concentric needle electromyograp hy. The outcome was defined at the end of 6 months into poor (Barthel Index score < 12) and good (greater than or equal to 12). The relation ship of various prognostic variables was evaluated by biserial correla tion coefficient and stepwise discriminant analysis. Results - The mea n age of the patients was 30.4 years and 7 were females Fifteen patien ts had good and 16 had poor outcome. The variables significantly relat ed to the outcome included severity of weakness, denervation on EMG an d unrecordable central motor conduction time to tibialis anterior (CMC T-TA) and tibial somatosensory evoked potentials (SEPs). Combination o f severity of weakness and EMG had 90.3% predicting power. Addition of central sensory conduction time (CSCT) or central motor conduction ti me (CMCT) did not offer further advantage. Conclusion - Severity of we akness and denervation on EMG are most useful for predicting the outco me of ATM at 6 months although in early stage motor and somatosensory evoked potentials may be used instead of EMG.