Document/I have
DC. Jones (jones(AT)tdl.com)
Tue, 15 Apr 1997 14:18:38 -0700
Title
The prognosis of acute and subacute transverse myelopathy based on early signs and symptoms.
Author
Ropper AH; Poskanzer DC
Source
Ann Neurol, 1978 Jul, 4:1, 51-9
Abstract
Fifty-two patients with acute and subacute transverse myelopathy (TM) were evaluated at the Massachusetts General
Hospital between 1955 and 1975 and followed for 1 to 23 years (average, 5). Nineteen had symptoms of a recent
acute infectious illness, 3 had cancer, and 1 had undergone a recent operation. There were four types of initial symptom.
Twenty-four patients had paresthesias at the onset of the illness, 18 had pain, usually interscapular, 7 had leg weakness,
and 3 had urine retention. Prognosis depended on the nature of the onset of TM. An acute catastrophic onset was
generally associated with back pain and led to a poor outcome in 7 and a good outcome in only 1 of 11 patients. A
subacute progressive onset over several days to four weeks, generally with ascending paresthesias or leg weakness,
was associated with a good outcome in 15 and fair outcome in 17 of 37 patients. Preceding febrile illness, treatment
with corticosteroids, and the nature of CSF abnormalities had no effect on outcome. Multiple sclerosis evolved in 7
patients during the follow-up period. Because of the frequency with which mass lesions were missed, the need for
myelography in the diagnosis of TM is emphasized. The distinguishing clinical characteristics of TM provide guidelines
for diagnosis and prognosis.
Language of Publication
English
Unique Identifier
79019934 "This is the document I have". //DCJones