Prabhakar S, Syal P, Singh P, Lal V, Khandelwal N, Das C P
Departments of Neurology and Radiodiagnosis, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India.
Neurol India. 1999 Dec;47(4):294-9.
Fifty seven patients (42 males and 15 females) with non-compressive myelopathy were studied from 1997 to 1999. Acute transverse myelitis (ATM) was the commonest (31) followed by Vit B12 deficiency myelopathy (8), primary progressive multiple sclerosis (5), hereditary spastic paraplegia (3), tropical spastic paraplegia (2), subacute necrotising myelitis (1), radiation myelitis (1), syphilitic myelitis (1) and herpes zoster myelitis (1). 4 cases remained unclassified. In the ATM group, mean age was 30.35 years, antecedent event was observed in 41.9% case, 25 cases had symmetrical involvement and most of the cases had severe deficit at onset. CSF study carried out in 23 patients of ATM revealed rise in proteins (mean 147.95mg%, range 20-1200 mg/dL) and pleocytosis (mean 20.78/cumm, range 0-200 mm3). Oligoclonal band (OCB) was present in 28% of cases of ATM. The most common abnormality detected was a multisegment hyperintense lesion on T2W images, that occupied the central area on cross section. In 6 patients hyperintense signal was eccentric in location. MRI was normal in 4 cases of ATM. Thus ATM is the leading cause of non-compressive myelopathy. Clinical features combined with MRI findings are helpful in defining the cause of ATM.
1997年至1999年期间，对57例非压迫性脊髓病患者（42例男性和15例女性）进行了研究。急性横贯性脊髓炎（ATM）最为常见（31例），其次是维生素B12缺乏性脊髓病（8例）、原发性进行性多发性硬化症（5例）、遗传性痉挛性截瘫（3例）、热带痉挛性截瘫（2例）、亚急性坏死性脊髓炎（1例）、放射性脊髓炎（1例）、梅毒性脊髓炎（1例）和带状疱疹性脊髓炎（1例）。4例仍未分类。在ATM组中，平均年龄为30.35岁，41.9%的病例有前驱事件，25例有对称性受累，大多数病例起病时就有严重功能缺损。对23例ATM患者进行的脑脊液检查显示蛋白升高（平均147.95mg%，范围20 - 1200mg/dL）和细胞增多（平均20.78/立方毫米，范围0 - 200立方毫米）。28%的ATM病例存在寡克隆带（OCB）。检测到的最常见异常是T2加权图像上的多节段高信号病变，在横断面上占据中央区域。6例患者的高信号位于偏心位置。4例ATM患者的MRI正常。因此，ATM是非压迫性脊髓病的主要原因。临床特征与MRI表现相结合有助于明确ATM的病因。
