Prognosis of Patients with Acute Myelitis; A Single Hospital-based Retrospective Analysis
Ji-Sun Kim, MD, Jae Hong Jang, MD
Department of Neurology, Korea University Medical Center, Seoul, Korea
Acute myelitis (AM) may be the initial presentation of multiple sclerosis (MS) or neuromyelitisoptica
(NMO). Therefore, predicting conversion risk to MS or NMO is one of many key considerations in the
management of patients with AM. To identify the clinical and laboratory variables in patients with
first-ever AM that predict relapses or conversion to NMO or MS. We selected patients who met the
following criteria; (1) patients who were visited to our hospital for myelitis as first-ever inflammatory
disorders in central nervous system from May 2006 to April 2011, (2) at least 24 months follow-up
after onset of symptoms. We reviewed medical records to recruit data related to demographics,
clinical features, and ancillary tests. The prognostic values of all variables were analyzed for
conversion to MS or NMO. Of 31 patients with AM, 5 patients (mean age 32.6 years) converted to
MS (3 women) or NMO (2 women), and 26 (18 men and 8 women, mean age 45.0 years) remained
monophasic. Mean follow-up time was 6.1 years. Female gender (p = 0.008) and dissemination in
space on MRI by MAGNIMS criteria (p = 0.029) were associated with conversion to MS or
NMO.There were no significant differences in age of onset, clinical characteristics, CSF findings,
spinal MRI or evoked potentials between two subgroups. Brain lesions and being female with AM
may be risk factors in the development of MS or NMO.
Journal of Multiple Sclerosis 3(1):20-25, 2012
