Contributions
Abstract: P977
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Diagnosis and differential diagnosis
Introduction and aims: Longitudinally extensive transverse myelitis (LETM) is defined as a spinal cord lesion that extends over three or more vertebral segments. The clinical presentation of LETM consist of paraparesis or tetraparesis, sensory disturbances, and gait, bladder, and bowel dysfunction. LETM encompasses a broad list of differential diagnoses where many of which have widely variable treatments and outcomes. In this study, we aimed to describe the epidemiological, clinical, radiologic, laboratory findings and treatment outcomes of LETM patients.
Methods: In this retrospective single-center study, all LETM patients who have been followed up in our center between April 2010 - January 2017 were evaluated in terms of epidemiological, clinical, radiological, cerebrospinal fluid findings, etiologies and treatment outcomes.
Results: Total 105 patients ( 31 males,74 females ) were reviewed. Median age of onset was 40 (range 12-76 years).We classified our patients according to their etiologies as autoimmune diseases (n=70), infections (n=8, 7,6%), vascular pathologies (n=6,5,7%) , others ( n=14, 13,3% hydrocephalus, radiation myelitis, Leber hereditary optic neuropathy, hypertensive myelopathy, B12 deficiency trauma etc.), and undetermined etiologies(n=8 7,6%). Autoimmune disease presenting with LETM were neuromyelitis optica (NMO) (n=43, 40,9%); multiple sclerosis (MS) (n=8,7,6%); connective tissue disorder (n=15 14,2%); acute disseminated encephalomyelitis (n=1); parainfectious (n=2) and paraneoplastic syndrome (n=2). Clinically 35 patients (33,3%) had optic neuritis either simultaneus or later onset with LETM. Among them 26 were clinically diagnosed as NMO, one had MS, one had Behçet's syndrome, one had Leber's hereditary optic neuropathy, and the last had connective tissue disorder. LETM presenting with paraneoplastic syndrome were finally diagnosed as B cell lymphoma and gastric adenocarcinoma.
Conclusions: To predict the prognosis of the first LETM relapse, the radiological and cerebrospinal fluid findings is essential. Although the final differential diagnosis is mainly among the central nervous system demyelinating autoimmune diseases group there can be some other diseases that are totaly different in terms pathogenesis and therefore treatment. Our series represents different final diagnosis that should be included during the clinical work-up of the patient.
Disclosure: Ezgi YILMAZ:nothing to disclose.
Aslı TUNCER:nothing to disclose.
Farid Khasiyev:nothing to disclose.
Ekim Gümeler:nothing to disclose.
Ahmet Turan ILICA:nothing to disclose.
Rahşan GOCMEN:nothing to disclose.
Rana KARABUDAK:nothing to disclose.
Abstract: P977
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Diagnosis and differential diagnosis
Introduction and aims: Longitudinally extensive transverse myelitis (LETM) is defined as a spinal cord lesion that extends over three or more vertebral segments. The clinical presentation of LETM consist of paraparesis or tetraparesis, sensory disturbances, and gait, bladder, and bowel dysfunction. LETM encompasses a broad list of differential diagnoses where many of which have widely variable treatments and outcomes. In this study, we aimed to describe the epidemiological, clinical, radiologic, laboratory findings and treatment outcomes of LETM patients.
Methods: In this retrospective single-center study, all LETM patients who have been followed up in our center between April 2010 - January 2017 were evaluated in terms of epidemiological, clinical, radiological, cerebrospinal fluid findings, etiologies and treatment outcomes.
Results: Total 105 patients ( 31 males,74 females ) were reviewed. Median age of onset was 40 (range 12-76 years).We classified our patients according to their etiologies as autoimmune diseases (n=70), infections (n=8, 7,6%), vascular pathologies (n=6,5,7%) , others ( n=14, 13,3% hydrocephalus, radiation myelitis, Leber hereditary optic neuropathy, hypertensive myelopathy, B12 deficiency trauma etc.), and undetermined etiologies(n=8 7,6%). Autoimmune disease presenting with LETM were neuromyelitis optica (NMO) (n=43, 40,9%); multiple sclerosis (MS) (n=8,7,6%); connective tissue disorder (n=15 14,2%); acute disseminated encephalomyelitis (n=1); parainfectious (n=2) and paraneoplastic syndrome (n=2). Clinically 35 patients (33,3%) had optic neuritis either simultaneus or later onset with LETM. Among them 26 were clinically diagnosed as NMO, one had MS, one had Behçet's syndrome, one had Leber's hereditary optic neuropathy, and the last had connective tissue disorder. LETM presenting with paraneoplastic syndrome were finally diagnosed as B cell lymphoma and gastric adenocarcinoma.
Conclusions: To predict the prognosis of the first LETM relapse, the radiological and cerebrospinal fluid findings is essential. Although the final differential diagnosis is mainly among the central nervous system demyelinating autoimmune diseases group there can be some other diseases that are totaly different in terms pathogenesis and therefore treatment. Our series represents different final diagnosis that should be included during the clinical work-up of the patient.
Disclosure: Ezgi YILMAZ:nothing to disclose.
Aslı TUNCER:nothing to disclose.
Farid Khasiyev:nothing to disclose.
Ekim Gümeler:nothing to disclose.
Ahmet Turan ILICA:nothing to disclose.
Rahşan GOCMEN:nothing to disclose.
Rana KARABUDAK:nothing to disclose.