Ganelin-Cohen E, Konen O, Nevo Y, et al. Prognostic Parameters of Acute Transverse Myelitis in Children [published online ahead of print, 2020 Aug 18]. J Child Neurol. 2020;883073820947512. doi:10.1177/0883073820947512
Acute transverse myelitis is a rare and disabling disorder.
Data on the imaging features in children are sparse. The aim of this study was
to describe the clinical and magnetic resonance imaging findings characteristic
of pediatric idiopathic acute transverse myelitis and to identify those with
prognostic value. The database of a tertiary pediatric medical center was
retrospectively reviewed for patients aged less than 18 years who were diagnosed
in 2002-2017 with acute transverse myelitis that was not associated with
recurrence of a demyelinating autoimmune event. Data were collected on
clinical, laboratory, and imaging findings and outcome. A total of 23 children
(11 male, 12 female) met the study criteria. Mean age at disease onset was 10
years, and mean duration of follow-up was 6 years 10 months. Spinal cord and
brain magnetic resonance imaging scans were performed on admission or shortly
thereafter. The most common finding was cross-sectional involvement, in 16
patients (70%). The mean number of involved spinal segments was 8. The most
frequently involved region was the thoracic spine, in 17 patients (74%).
Clinical factors predicting good prognosis were cerebrospinal fluid
pleocytosis, absence of tetraparesis, and prolonged time to nadir. In
conclusion, most children with acute transverse myelitis appear to have a good
outcome. Prompt diagnosis and treatment are important. Further research is
needed in a larger sample to evaluate the predictive value of imaging features.