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Short transverse myelitis in Chinese patients with neuromyelitis optica spectrum disorders

  • Author Footnotes
    1 Hongtao Hu and Xiaofan You contributed equally to this manuscript.
    Hongtao Hu
    Correspondence
    Correspondence to: Department of Neurology, Beijing Jishuitan Hospital, Xinjiekou No. 31 East Street, Xicheng District, Beijing 100035, China.
    Footnotes
    1 Hongtao Hu and Xiaofan You contributed equally to this manuscript.
    Affiliations
    Department of Neurology, Beijing Jishuitan Hospital, Beijing, China
    Search for articles by this author
  • Author Footnotes
    1 Hongtao Hu and Xiaofan You contributed equally to this manuscript.
    Xiaofan You
    Footnotes
    1 Hongtao Hu and Xiaofan You contributed equally to this manuscript.
    Affiliations
    Department of Neurology, Beijing Jishuitan Hospital, Beijing, China
    Search for articles by this author
  • Jing Ye
    Correspondence
    Correspondence to: Department of Neurology, XuanWu Hospital, Capital Medical University, 45 Changchun Street, Xicheng District, Beijing 100053, China.
    Affiliations
    Department of Neurology, XuanWu Hospital, Capital Medical University, Beijing, China
    Search for articles by this author
  • Author Footnotes
    1 Hongtao Hu and Xiaofan You contributed equally to this manuscript.
Published:February 19, 2018DOI:https://doi.org/10.1016/j.msard.2018.02.022

      Highlights

      • STM was the first myelitis event in 19.8% of NMOSD patients.
      • Patients with STM suffered less motor and bowel or bladder disability.
      • Compared with LETM, STM patients had better recovery, but earlier relapse.
      • Most STM lesions were ≥2 vertebral segments and involved the central grey matter.
      • Initial STM does not exclude consideration of NMOSD diagnosis.

      Abstract

      Background

      Short transverse myelitis (STM) is considered uncommon in neuromyelitis optica spectrum disorders (NMOSD). Poor recognition of STM occurring in NMOSD may lead to increased delay in diagnosis and appropriate treatment.

      Objectives

      The aim of this study was to assess the frequency and characteristics of STM in Chinese patients with NMOSD.

      Methods

      We enrolled 91 patients with NMOSD based on the 2015 International Consensus Diagnostic Criteria for NMOSD. The patients were divided into STM group and longitudinally extensive transverse myelitis (LETM) group according to the length of initial spinal cord lesions at the initial myelitis manifestation of NMOSD.

      Results

      Initial STM was observed in 18 patients (18/91, 19.8%). The STM episode was the first manifestation of NMOSD in 9 patients (50%) and preceded by optic neuritis in 3 patients (16.7%), area postrema syndrome in 5(27.8%) and brainstem syndrome in 1(5.6%). Compared to the NMOSD patients with an initial LETM, patients with STM suffered less motor and bowel or bladder disability, had minor EDSS at clinical onset, but suffered earlier relapse (P<.05). Thirteen patients had single short spinal lesion (13/18, 72.2%) and 5 patients had two short lesions. Of the 23 STM lesions, 4 lesions spanned 2.5 vertebral segments, 12 showed a length of continuous 2 vertebral segments, 7 were confined to single vertebral segment. The lesions on axial imaging involved the central grey matter in 61.1% (11/18) patients with STM and in 95.9%(70/73)patients with LETM (P<.05). Both the patients with STM(50%)and LETM (34.2%) had brain lesions.

      Conclusions

      Initial STM does not exclude consideration of NMOSD diagnosis.

      Keywords

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