Kalita J, Misra U K, Mandal S K
Department of Neurology, SGPGIMS, Lucknow, India.
Acta Neurol Scand. 1998 Jul;98(1):60-3. doi: 10.1111/j.1600-0404.1998.tb07379.x.
The role of clinical, MRI and neurophysiological parameters in predicting the outcome of acute transverse myelitis (ATM) is reported.
Thirty-one patients with ATM were subjected to clinical, MRI, somatosensory and motor evoked potential studies in both upper and lower limbs and concentric needle electromyography. The outcome was defined at the end of 6 months into poor (Barthel Index score <12) and good (> or =12). The relationship of various prognostic variables was evaluated by biserial correlation coefficient and stepwise discriminant analysis.
The mean age of the patients was 30.4 years and 7 were females. Fifteen patients had good and 16 had poor outcome. The variables significantly related to the outcome included severity of weakness, denervation on EMG and unrecordable central motor conduction time to tibialis anterior (CMCT-TA) and tibial somatosensory evoked potentials (SEPs). Combination of severity of weakness and EMG had 90.3% predicting power. Addition of central sensory conduction time (CSCT) or central motor conduction time (CMCT) did not offer further advantage.
Severity of weakness and denervation on EMG are most useful for predicting the outcome of ATM at 6 months although in early stage motor and somatosensory evoked potentials may be used instead of EMG.
报告了临床、MRI和神经生理学参数在预测急性横贯性脊髓炎（ATM）预后中的作用。
对31例ATM患者进行了临床、MRI、上下肢体感和运动诱发电位研究以及同心针肌电图检查。结局在6个月末定义为差（Barthel指数评分<12）和好（≥12）。通过双列相关系数和逐步判别分析评估各种预后变量之间的关系。
患者的平均年龄为30.4岁，女性7例。15例患者结局良好，16例结局较差。与结局显著相关的变量包括肌无力的严重程度、肌电图上的失神经以及胫前肌的中枢运动传导时间（CMCT-TA）和胫神经体感诱发电位（SEPs）不可记录。肌无力严重程度和肌电图的组合具有90.3%的预测能力。增加中枢感觉传导时间（CSCT）或中枢运动传导时间（CMCT）并无进一步优势。
肌无力的严重程度和肌电图上的失神经对预测6个月时ATM的结局最有用，尽管在早期阶段可以使用运动和体感诱发电位代替肌电图。
