ACUTE TRANSVERSE MYELITIS IN CHILDHOOD - 9 CASES AND REVIEW OF THE LITERATURE

Acute transverse myelitis (ATM) is a rare disease in childhood and ado lescence. It is characterized by paraplegia with or without sensory sy mptoms and bladder dysfunction, and typically manifests itself over a period of hours to 1 week. This is a report of nine patients who were treated between 1993 and 1996, To exclude treatable conditions, spinal and cranial MRI with and without contrast medium, electrophysiologic tests, and CSF examinations are performed as soon as possible after on set. At present post- or parainfectious inflammation is thought to be the most frequent cause of ATM, Some causes of ATM can be proved only by follow-up examination. The most important differential diagnoses ar e multiple sclerosis and Guillain-Barre syndrome with its variants. Af ter exclusion of spinal cord compression, and if specific antibiotic t reatment is not possible, a 3-day high-dose IV steroid pulse therapy i s the most promising treatment, Prognosis is variable and residual sym ptoms are common. A controlled multicenter study is suggested to asses s epidemiology, etiology, and prognosis of ATM.