Peculiarities of transverse myelitis: retrospective institutional cohort study.
Keywords:transverse myelitis, cohort study, autoimmune myelitis, antibodies
Transverse myelitis (TM) is a clinical syndrome in which an inflammatory process causes neuronal damage to the spinal cord, leading to varying degrees of muscle weakness, sensory changes, and autonomic dysfunction. MT can be a form of presentation of a multi-focal CNS disease, multi-systemic, infectious, paraneoplastic, demyelinating, autoimmune or idiopathic disease.The purpose of the research was to analyze the cases of transverse myelitis codes in patients treated and hospitalized in the “Diomid Gherman” Institute of Neurology and Neurosurgery.Material and method: 22905 medical records of patients treated in the Institute of Neurology and Neurosurgery between February 2018 and April 2022 were analyzed, 53 patients diagnosed with transverse myelitis were selected and 44 records were eligible, analyzed and included in the study. Results: The average age of the subjects included in the research was 50.9±11.7 years, they were on treatment for an average of 11.2±8.04 days. Neurological manifestations were presented in 43 people. The clinical presentation included: sensitivity disorders (75%), sphincteric disorders (61.4%), limb paresthesia (40.9%), motility disorders (95.5%), fever (4.5%), depression (6.8%), headache (15.9%), back pain (15.9%). The most frequent investigations performed on patients in the study group was CT/MRI thoracic, cervical, lumbo-sacral, cerebral, EMG. Lumbar puncture was performed in 32 patients (72.7%) with CSF examination. Laboratory analyzes showed signs of inflammation - 54.5%, elevated blood sugar - 40.8%, dyslipidemia - 38.6% and anemia - 25%. Corticosteroid treatment was performed in 25 subjects (56.8%) with improvement in most cases (80%). Frequent complications were urinary infection (52.3%), pneumonia (9.1%), 2 deaths (4.5%). Conclusion: The analysis of the institutional cohort of patients with transverse myelitis confirmed that the diagnosis of MT continues to present a challenge and requires a complex approach, correct both clinical and paraclinical.
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