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KMID : 0361420120360030328
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Journal of Korean Academy of Rehabilitation Medicine
2012 Volume.36 No. 3 p.328 ~ p.333
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Spinal Cord Atrophy and Early Motor Recovery following Transverse Myelitis in Pediatric Patients
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Kim Jung-Yoon
Kim Sang-Joon
Bang Moon-Suk
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Abstract
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Objective: To compare the motor recovery following transverse myelitis in pediatric patients with and without spinal cord atrophy.
Methods: 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% confi dence 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.
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KEYWORD
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Transverse myelitis, Spinal cord atrophy, Motor recovery, Pediatrics
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