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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Article info
Publication history
Published online: February 19, 2018
Accepted:
February 17,
2018
Received in revised form:
February 12,
2018
Received:
December 14,
2017
Identification
Copyright
© 2018 Elsevier B.V. All rights reserved.
