Persistent Motor Deficits Predict Long-Term Bladder Dysfunction in Children Following Acute Transverse Myelitis

2008 ◽  
Vol 180 (4S) ◽  
pp. 1774-1777 ◽  
Author(s):  
Daniel G. DaJusta ◽  
Matthew S. Wosnitzer ◽  
Joseph G. Barone
Keyword(s):  
Bladder Dysfunction ◽  
Transverse Myelitis ◽  
Motor Deficits ◽  
Acute Transverse Myelitis

scholarly journals Clinical Approach to Pediatric Transverse Myelitis, Neuromyelitis Optica Spectrum Disorder and Acute Flaccid Myelitis

Children ◽  
2019 ◽  
Vol 6 (5) ◽  
pp. 70 ◽  
Author(s):  
Cynthia Wang ◽  
Benjamin Greenberg
Keyword(s):  
Clinical Presentation ◽  
Bladder Dysfunction ◽  
Transverse Myelitis ◽  
Bowel Dysfunction ◽  
Spectrum Disorder ◽  
Clinical Approach ◽  
Acute Flaccid Myelitis ◽  
Acute Transverse Myelitis ◽  
Immune Mediated

Pediatric transverse myelitis (TM) is an acquired, immune-mediated disorder that leads to injury of the spinal cord and often manifests as weakness, numbness, bowel dysfunction, and/or bladder dysfunction. Multiple etiologies for myelitis can result in a similar clinical presentation, including idiopathic transverse myelitis (TM), multiple sclerosis (MS), neuromyeltis optica spectrum disorder (NMOSD) associated with anti-aquaporin 4 antibodies, MOG antibody-associated disease, and acute flaccid myelitis (AFM). Diagnosis relies on clinical recognition of the syndrome and confirming inflammation through imaging and/or laboratory studies. Acute treatment is targeted at decreasing immune-mediated injury, and chronic preventative therapy may be indicated if TM is determined to be a manifestation of a relapsing disorder (i.e., NMOSD). Timely recognition and treatment of acute transverse myelitis is essential, as it can be associated with significant morbidity and long-term disability.

Neuromyelitis optica spectrum disorder (NMOSD) presenting as acute transverse myelitis with positive aquaporin 4 antibodies

2021 ◽  
Vol 14 (1) ◽  
pp. e238992
Author(s):  
Katherine Thornley ◽  
Carlo Canepa
Keyword(s):  
Spinal Cord ◽  
Transverse Myelitis ◽  
Aquaporin 4 ◽  
Sensory Level ◽  
Mri Scan ◽  
Acute Transverse Myelitis ◽  
Longitudinal Extensive Transverse Myelitis ◽  
Oral Steroids ◽  
Extensive Transverse Myelitis

An 80-year-old, previously healthy patient presents with acute transverse myelitis with sensory level at T8. The MRI scan of the spinal cord showed longitudinal extensive transverse myelitis, and she tested positive for aquaporin 4 antibodies in serum. She received treatment with intravenous and oral steroids, with no improvement and then underwent plasma exchange. She was then started on azathioprine for prevention of relapses, while continuing physiotherapy and occupational therapy. Eventually, she was transferred to a specialised spinal cord centre for long-term rehabilitation.

scholarly journals Urodynamic profile in acute transverse myelitis patients: Its correlation with neurological outcome

2017 ◽  
Vol 08 (01) ◽  
pp. 044-048 ◽  
Author(s):  
Anupam Gupta ◽  
Sushruth Nagesh Kumar ◽  
Arun B. Taly
Keyword(s):  
Neurological Outcome ◽  
Bladder Dysfunction ◽  
Transverse Myelitis ◽  
Inpatient Rehabilitation ◽  
Neurological Status ◽  
Rehabilitation Unit ◽  
Overactive Detrusor ◽  
Acute Transverse Myelitis ◽  
Acontractile Detrusor ◽  
Bladder Management

ABSTRACT Objective: The objective of this study was to observe urodynamic profile of acute transverse myelitis (ATM) patients and its correlation with neurological outcome. Patients and Methods: This prospective study was conducted in the neurorehabilitation unit of a tertiary university research hospital from July 2012 to June 2014. Forty-three patients (19 men) with ATM with bladder dysfunction, admitted in the rehabilitation unit, were included in this study. Urodynamic study (UDS) was performed in all the patients. Their neurological status was assessed using ASIA impairment scale and functional status was assessed using spinal cord independence measure. Bladder management was based on UDS findings. Results: In total, 17 patients had tetraplegia and 26 had paraplegia. Thirty-six patients (83.7%) had complaints of increased frequency and urgency of urine with 26 patients reported at least one episode of urge incontinence. Seven patients reported obstructive urinary complaints in the form of straining to void with 13 patients reported both urgency and straining to void and 3 also had stress incontinence. Thirty-seven (86.1%) patients had neurogenic overactive detrusor with or without sphincter dyssynergia and five patients had acontractile detrusor on UDS. No definitive pattern was observed between neurological status and bladder characteristics. All patients showed significant neurological and functional recovery with inpatient rehabilitation (P< 0.05 and P< 0.001, respectively). Conclusions: The problem of neurogenic bladder dysfunction is integral to ATM. Bladder management in these patients should be based on UDS findings. Bladder characteristics have no definitive pattern consistent with the neurological status.

scholarly journals Acute flaccid myelitis: long-term outcomes recorded in the CAPTURE study compared with paediatric transverse myelitis

2021 ◽  
Vol 3 (1) ◽  
pp. e000127
Author(s):  
Benjamin Greenberg ◽  
Patricia Plumb ◽  
Gary Cutter ◽  
Janet Dean ◽  
Allen Desena ◽  
...  
Keyword(s):  
Transverse Myelitis ◽  
Motor Deficits ◽  
Long Term Outcomes ◽  
Radiographic Findings ◽  
Acute Flaccid Myelitis ◽  
Restricted Form ◽  
The Usa ◽  
Observational Cohort

BackgroundSince 2014, the USA has documented three outbreaks of acute flaccid myelitis (AFM). Unique features and treatment responses of this myelitis variant have not been prospectively studied. This study prospectively measured outcomes in paediatric myelitis patients relative to treatments.MethodsThis was a prospective, multicentre, non-randomised, observational cohort study. The study duration was 5 years and the length of follow-up was 1 year. This study collected data from children and families in North America. Patients were enrolled at academic centres with expertise in myelitis or online via a web portal. Paediatric patients diagnosed with myelitis were eligible for enrolment in the study within 6 months of onset of symptoms. Patients were characterised as transverse myelitis (TM) or the AFM variant based on clinical and radiographic findings.ResultsThe cohort of 90 patients included patients with AFM and TM. Of the 51 patients with AFM there was evidence of two clinically relevant patterns. This included a grey matter restricted form of AFM and a cohort with concomitant white matter that could explain lower extremity motor deficits in patients with lesions restricted to the cervical spine. The improvement in deficits with the use of corticosteroids was similar to what was observed in the TM cohort (p=0.97).ConclusionsClinicians should consider on a case by case basis the approach to therapy for AFM patients. Prospective controlled studies of long-term outcomes would be useful in this growing patient population.

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