Tags

Type your tag names separated by a space and hit enter

The frequency of longitudinally extensive transverse myelitis in MS: A population-based study.
Mult Scler Relat Disord. 2020 Jan; 37:101487.MS

Abstract

BACKGROUND

Determining the frequency of longitudinally-extensive transverse myelitis (LETM: T2-lesion ≥3 vertebral segments) in multiple sclerosis (MS) is essential to assess its utility in differentiating from aquaporin-4-IgG (AQP4-IgG) positive neuromyelitis optica spectrum disorder (NMOSD) and myelin-oligodendrocyte-glycoprotein-IgG (MOG-IgG) myelitis. We sought to determine the frequency of LETM in MS during a myelitis attack.

METHODS

We identified Olmsted County (MN, USA) residents on 12/31/2011 with inflammatory demyelinating disease. Inclusion criteria were: 1) Clinical myelitis episode accompanied by a new spinal magnetic resonance imaging (MRI) lesion (≤6 weeks from onset); 2) MS diagnosis by 2010 McDonald criteria; 3) Seronegative for AQP4-IgG and MOG-IgG. MRI characteristics were determined.

RESULTS

Sixty-seven patients (median age at myelitis: 41 years [range, 16-65]; 76% females) with 92 myelitis attacks accompanied by a new MRI spinal cord lesion were identified. The frequency of LETM was 0%. The median T2-hyperintense lesion length in vertebral segments was 1.0 (range, 0.5-2.5) and 82/92 (89%) were peripheral in location on axial sequences; 58% had associated gadolinium enhancement. Two patients (2% of attacks) had multiple short lesions resembling LETM on sagittal images but axial sequences confirmed multiple non-contiguous short lesions.

CONCLUSION

LETM is rare in adult MS myelitis and its presence should prompt evaluation for AQP4-IgG, MOG-IgG or other etiologies. Careful scrutiny of axial images is important as coalescence of multiple short lesions may lead to the artifactual appearance of an LETM.

Authors+Show Affiliations

Departments of Neurology, Mayo Clinic, Rochester, MN, USA.Departments of Radiology, Mayo Clinic, Rochester, MN, USA.Departments of Neurology, Mayo Clinic, Rochester, MN, USA.Departments of Neurology, Mayo Clinic, Rochester, MN, USA; Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.Departments of Neurology, Mayo Clinic, Rochester, MN, USA.Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK; Department of Pharmacology, University of Oxford, Oxford, UK.Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK.Departments of Neurology, Mayo Clinic, Rochester, MN, USA; Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA. Electronic address: Flanagan.Eoin@mayo.edu.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31707235

Citation

Asnafi, Solmaz, et al. "The Frequency of Longitudinally Extensive Transverse Myelitis in MS: a Population-based Study." Multiple Sclerosis and Related Disorders, vol. 37, 2020, p. 101487.
Asnafi S, Morris PP, Sechi E, et al. The frequency of longitudinally extensive transverse myelitis in MS: A population-based study. Mult Scler Relat Disord. 2020;37:101487.
Asnafi, S., Morris, P. P., Sechi, E., Pittock, S. J., Weinshenker, B. G., Palace, J., Messina, S., & Flanagan, E. P. (2020). The frequency of longitudinally extensive transverse myelitis in MS: A population-based study. Multiple Sclerosis and Related Disorders, 37, 101487. https://doi.org/10.1016/j.msard.2019.101487
Asnafi S, et al. The Frequency of Longitudinally Extensive Transverse Myelitis in MS: a Population-based Study. Mult Scler Relat Disord. 2020;37:101487. PubMed PMID: 31707235.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The frequency of longitudinally extensive transverse myelitis in MS: A population-based study. AU - Asnafi,Solmaz, AU - Morris,P Pearse, AU - Sechi,Elia, AU - Pittock,Sean J, AU - Weinshenker,Brian G, AU - Palace,Jacqueline, AU - Messina,Silvia, AU - Flanagan,Eoin P, Y1 - 2019/10/31/ PY - 2019/07/08/received PY - 2019/10/27/revised PY - 2019/10/28/accepted PY - 2019/11/11/pubmed PY - 2019/11/11/medline PY - 2019/11/11/entrez KW - Aquaporin-4 KW - Longitudinally extensive spinal cord lesion KW - Longitudinally extensive transverse myelitis KW - Multiple sclerosis KW - Myelin oligodendrocyte glycoprotein KW - Myelitis SP - 101487 EP - 101487 JF - Multiple sclerosis and related disorders JO - Mult Scler Relat Disord VL - 37 N2 - BACKGROUND: Determining the frequency of longitudinally-extensive transverse myelitis (LETM: T2-lesion ≥3 vertebral segments) in multiple sclerosis (MS) is essential to assess its utility in differentiating from aquaporin-4-IgG (AQP4-IgG) positive neuromyelitis optica spectrum disorder (NMOSD) and myelin-oligodendrocyte-glycoprotein-IgG (MOG-IgG) myelitis. We sought to determine the frequency of LETM in MS during a myelitis attack. METHODS: We identified Olmsted County (MN, USA) residents on 12/31/2011 with inflammatory demyelinating disease. Inclusion criteria were: 1) Clinical myelitis episode accompanied by a new spinal magnetic resonance imaging (MRI) lesion (≤6 weeks from onset); 2) MS diagnosis by 2010 McDonald criteria; 3) Seronegative for AQP4-IgG and MOG-IgG. MRI characteristics were determined. RESULTS: Sixty-seven patients (median age at myelitis: 41 years [range, 16-65]; 76% females) with 92 myelitis attacks accompanied by a new MRI spinal cord lesion were identified. The frequency of LETM was 0%. The median T2-hyperintense lesion length in vertebral segments was 1.0 (range, 0.5-2.5) and 82/92 (89%) were peripheral in location on axial sequences; 58% had associated gadolinium enhancement. Two patients (2% of attacks) had multiple short lesions resembling LETM on sagittal images but axial sequences confirmed multiple non-contiguous short lesions. CONCLUSION: LETM is rare in adult MS myelitis and its presence should prompt evaluation for AQP4-IgG, MOG-IgG or other etiologies. Careful scrutiny of axial images is important as coalescence of multiple short lesions may lead to the artifactual appearance of an LETM. SN - 2211-0356 UR - https://www.unboundmedicine.com/medline/citation/31707235/The_frequency_of_longitudinally_extensive_transverse_myelitis_in_MS:_A_population_based_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S2211-0348(19)30476-6 DB - PRIME DP - Unbound Medicine ER -
Try the Free App:
Prime PubMed app for iOS iPhone iPad
Prime PubMed app for Android
Prime PubMed is provided
free to individuals by:
Unbound Medicine.