Idiopathic Acute Transverse Myelitis (ATM) is an inflammatory and immune-mediated disorder, distinct from infectious ATM, the ATM of systemic lupus erythematosus or Sjögren’s syndrome, and from spinal cord manifestations of multiple sclerosis. The prognosis is not well known.
This paper reports an evaluation of clinical, paraclinical and prognostic data in patients selected by new diagnostic criteria based on features described in classical idiopathic ATM.
Seventeen patients were retrospectively diagnosed (1996-2005) using the new diagnostic criteria that include clinical, radiological and biological features as well as tests excluding recognised causes of ATM. A telephone interview based survey was carried out in 2005 to obtain data on the clinical course.
Seven men and 10 women, aged 15-75 years (mean 39.8y) met the new criteria. The study showed that epidemiological and clinical findings as well as laboratory data were in agreement with those reported in the literature. Conversely, the prognosis was better than previously thought since 76 per cent of patients could walk without assistance. The clinical presentation of some patients and/or their progression towards other multifocal inflammatory disorders suggest links between ATM, neuromyelitis optica (NMO) and acute disseminated encephalomyelitis (ADEM).
Patients with idiopathic ATM, selected by new criteria, have a relatively good prognosis. ATM seems to be part of a continuum of neuroimmunological disorders including NMO and ADEM although the reasons for distinct focal features remain unclear.
© 2006 Elsevier Masson SAS. Tous droits réservés.