Prognostic Indicators of Acute Transverse Myelitis in 39 Children

Chen et al. published an article in 2013 describing factors that contributed to the prognosis of 39 children (17 boys, 22 girls) who fit the diagnostic criteria for acute transverse myelitis (ATM).  The diagnostic criteria were developed by The Transverse Myelitis Consortium Working Group in 2002.  Children were admitted to the Children’s Hospital of Chongqing Medical University between 1995 and 2008, and were followed for an average of 8.5 years.  Chen et al. aimed to determine what contributed to a poor functional recovery versus a good functional recovery in this group of children.  At follow-up, 22 (56%) of the children were completely functionally recovered, 9 (23%) had a good recovery with some residual effects, and 8 (21%) children were unable to walk unassisted and/or did not have complete control of urination.  Of the latter group, 3 (38%) did not receive the correct treatment during their attack of ATM.  Out of the total cohort, 24 (61%) of the children had an infection before experiencing ATM, and two children (5%) out of 39 eventually converted to multiple sclerosis.

Chen et al. found that there were several factors that predicted a poor prognosis in this population.  These factors included: a) A short amount of time from initial symptoms to the most impairment, b) A long period of time elapsed during which the most impairment was being experienced, c) Increased levels of protein in the cerebrospinal fluid, and d) A secondary infection.  Individuals that experienced any of the above-mentioned factors were more likely to have a poor prognosis.  Similar to other studies, Chen et al. found that long waiting times before getting treatment were associated with poor prognosis.  Some of their results are, however, in contrast to other studies.  Therefore, the researchers caution that, because their study looked at medical records from the past, had a small sample size, and short observation time, the prognostic indicators they found may not be completely accurate.

This summary was written by Gabrielle (GG) deFiebre, Research Associate at a Public Health non-profit in New York City who was diagnosed with Transverse Myelitis in 2009. GG volunteers with The Siegel Rare Neuroimmune Association. 

Original research: Chen L, Li J, Guo Z, Liao S, Jiang L. Prognostic Indicators of Acute Transverse Myelitis in 39 Children. Pediatr Neurol. 2013;49:397-400.