Myelitis. Clinical And Radiological Differences Between Multiple Sclerosis And Other Etiologies. (P4.073)
2015
OBJECTIVE: To analyze the demographic, clinical and radiological characteristics of patients who develop myelitis and to compare the characteristics of myelitis secondary to an initial onset of multiple sclerosis (MS) with other etiologies.
BACKGROUND: Transverse myelitis is an inflammation of the spinal cord that can be related to a number of diseases. Multiple sclerosis might be considered the most important of them because of its clinical course and associated disability.
DESIGN/METHODS: Single-center retrospective analysis (2000-2013) of patients who developed myelitis. Epidemiological (sex, age of onset), etiological, clinical and radiological variables were studied. Disability was assessed by EDSS scale.
RESULTS: Sample of 91 patients, of which 69.2[percnt] were women. Age of onset 37+/-12 years. Diagnostics: MS 57 (62[percnt]). Myelitis due to other etiologies: 34 (38[percnt]), highlighting idiopathic transverse myelitis (24[percnt]) and those associated with systemic diseases (6[percnt]). Clinical variables: MS patients were younger at the myelitis onset (35+/-11 vs. 41+/-13; p=0.02) and had a higher rate of sphincter involvement (40.4[percnt] vs. 27.3[percnt], p=0.05) with no other clinical differences. Radiological variables: Myelitis due to MS had most frequently a multifocal involvement (77.2[percnt] vs. 26.5[percnt], p=0.001), were in cervical region (82.5[percnt] vs. 64.7[percnt], p=0.05) and most often were located posteriorly (89.5[percnt] vs. 41.2 [percnt], p=0.001). Myelitis not due to MS were found most frequently in the anterior (47.1[percnt] vs. 24.6[percnt], p=0.02) and central cord (47.1[percnt] vs. 14.1[percnt], p=0.001). Lesion was larger in myelitis due to other etiologies (2.6 vs. 1.2, p=0.005). Disability at relapse was similar in both groups; recovery was better in patients with myelitis due to other etiologies (EDSS at 6 months [2 vs. 1.5, p=0.01]).
CONCLUSIONS: Over half of the patients with myelitis will be diagnosed with MS. Age of onset, sphincter involvement and radiological imaging can help to guide the diagnosis. Disclosure: Dr. Presas has nothing to disclose. Dr. Grau-Lopez has nothing to disclose. Dr. Hervas has nothing to disclose. Dr. Massuet-Vilamajo has nothing to disclose. Dr. Ramo has received research support from Biogen Idec.
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