Twenty-Year Clinical Profile of Idiopathic Transverse Myelitis in Children in Oman, a Gulf Country (P1.398)

Objective: Twenty-year clinical profile of idiopathic transverse myelitis in children in Oman. Background: Acute transverse myelitis formed a part of acute flaccid paralysis (AFP) program to eradicate poliomyelitis in Oman. All the children below 15 years age with AFP were referred to this hospital Design and Methods: A retrospective (1995-2014) study was carried out at Sultan Qaboos University Hospital which is a tertiary care center for all AFP cases in the country. The diagnosis of idiopathic transverse myelitis (ITM) was based on established criteria (Neurol 2002; 59:499-505). All the inpatient and electronic medical records were reviewed. The children with final diagnosis of ITM at the time of the discharge were included in the study. Neurophysiological tests, cerebrospinal fluid examination, MRI brain and spine were done in all. The children were followed up in the outpatient clinic. Results: Twenty-four children presented with features of acute TM. Five children excluded were 3 cases of neuromyelitis optica, one each case of spinal arteriovenous malformation and vasculitis. Nineteen (11F: 8M) children had ITM. The site of lesion was cervical spinal cord in 2, thoracic in 4 and cervicothoracic in 13. All but one had more than three vertebral segments involvement fitting the diagnosis of longitudinal TM. Age ranged between 5months to 11.8 years age, with a mean age of 6.4 years. Seven children were below 5 years age. Methylprednisolone was used in all. Additional intravenous immunoglobulin was used in 11. Sixteen children were on regular follow up and three were lost to follow up. A complete recovery was seen in 5 (31.2[percnt]), two were left with mild deficit while 8 had severe neurodeficit (68.7[percnt]). Conclusion: ITM was a crippling disease in children and the incidence was almost one case per million children population per year in this country. Disclosure: Dr. Koul has nothing to disclose. Dr. Alfutaisi has nothing to disclose. Dr. Sankhla has nothing to disclose.