Prognostic indicators of acute transverse myelitis in 39 children

Background: The Transverse Myelitis Consortium Working Group has proposed new diagnostic criteria for acute transverse myelitis. The purpose of the present study is to evaluate the relations between clinical variables and functional prognosis using new criteria.

Methods: We reviewed 39 Chinese cases meeting the new criteria, recorded clinical epidemiological data, and followed activities of daily living measuring scale (Modified Barthel Index).

Results: Thirty-nine children met new criteria for definite acute transverse myelitis in the past 14 years between 1995 and 2008. Mean follow-up time was 102.7 months. Conversion to multiple sclerosis occurred in two patients (5.1%). Those children with a short time to maximal deficits, long time of peak neurological impairment and initial time of treatment, increased protein levels of the cerebrospinal fluid, and secondary infection were more likely to have residual neurological deficits, resulting in lower qualities of life (P = 0.005, P = 0.003, P = 0.011, P = 0.0012, P = 0.000, respectively).

Conclusions: A short time to maximal deficits, long time of peak neurological impairment and initial time of treatment, increased protein levels of cerebrospinal fluid, and secondary infection played important roles in predicting poor prognosis.