Ann Rehabil Med.  2012 Jun;36(3):328-333. 10.5535/arm.2012.36.3.328.

Spinal Cord Atrophy and Early Motor Recovery following Transverse Myelitis in Pediatric Patients

• Kim JY
• Kim SJ
• Bang MS

• KMID: 2266737
• DOI: http://doi.org/10.5535/arm.2012.36.3.328

Abstract

OBJECTIVE
To compare the motor recovery following transverse myelitis in pediatric patients with and without spinal cord atrophy. METHOD: From January 1995 through December 2009, twenty children (8 boys and 12 girls with an onset at 5.7+/-3.8 years) that were diagnosed with transverse myelitis at a Children's Hospital in Korea, and undertaken an initial and follow-up spine magnetic resonance image (MRI) were included. Medical records and spine MRI scans were reviewed retrospectively. An initial MRI was taken 5.1+/-8.7 days after the onset. The interval between an initial and follow-up MRIs was 33.4+/-23.0 days. The motor recovery differences between subjects with and without spinal cord atrophy on follow-up MRIs were determined. Motor recovery was defined as the elevation of one or more grades of manual muscle tests of the Medical Research Council.
RESULTS
Eight patients had developed spinal cord atrophies and 12 patients had not. Of the 8 patients with spinal cord atrophy, 7 showed no motor improvement. Among the 12 patients without atrophy, 11 had motor improvement. Spinal cord atrophy on follow-up MRIs were related to the risk of no motor improvement (odds ratio=77.0, 95% confidence interval [4.114-1441.049], p-value=0.001).
CONCLUSION
Children with transverse myelitis who had developed spinal cord atrophy on follow-up MRIs had poor motor recovery than those who had not. The appearance of spinal cord atrophy on follow-up MRI could be an indicator of poor prognosis in pediatric transverse myelitis.

Keyword

Transverse myelitis; Spinal cord atrophy; Motor recovery; Pediatrics

MeSH Terms

Atrophy
Child
Follow-Up Studies
Humans
Korea
Magnetic Resonance Imaging
Magnetic Resonance Spectroscopy
Medical Records
Muscles
Myelitis, Transverse
Pediatrics
Prognosis
Retrospective Studies
Spinal Cord
Spine

Figure

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  Fig. 1 A flowchart of subjects included in this study.

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  Fig. 2 A, B, and C denotes the level of each cross-sectional view. Cross-sectional areas in atrophied spinal cord segments were measured using Marosis M-view 5.4.

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  Fig. 3 A T2-weighted sagittal view of the whole spine MRI of the patient (a 4 year-old girl) diagnosed as transverse myelitis (A) There was diffuse cord swelling below T5 level and (B) a spinal cord atrophy was detected with residual swelling in MRI taken 20 days after the initial one.

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