Safia Bano, Muhammad Athar Javed, Ahsan Numan.
Longitudinally Extensive Transverse Myelitis and Neuromyelitis Optica spectrum Disorder: a Tertiary Care Centre Experience.
Pak J Neurological Sci Jan ;15(4):36-40.

OBJECTIVE: To determine the frequency of longitudinally extensive transverse myelitis and Causes of longitudinally extensive transverse myelitis METHODOLOGY: A Cross-Sectional, retrospective study was conducted at Neurology Department, Mayo Hospital, Lahore from 1st January 2015 to 31st December 2015. Patients were included from inpatient with history of weakness of lower limbs/all four limbs with or without visual disturbances. History and clinical examination was consistent with transverse myelitis. Neuroimaging (MRI brain, (orbit in case of optic neuritis) and spinal cord) was done followed by LP/CSF, Vasculitis screening. RESULTS: Total 37 patients of transverse myelitis (TM) (1287 patients were admitted in neurology department with various neurological disorders in study year) were enrolled in this study. Demographic data showed age distribution between 15-50 years. Out of 37patients, LETM was present in 16 patients. They were predominantly females (62.5% versus 37.5% male) patients. With majority has normal MRI brain (93.8% versus 6.2% abnormal). Most common cause of LETM was Neuro Myelitis Optica (NMOSD) 93.8% versus 6.2% Multiple Sclerosis (MS). CONCLUSION: Longitudinally extensive transverse myelitis (LETM) is not an uncommon disease, however, it remains under-diagnosed in our clinical practice due to either lack or cost of diagnostic facilities. LETM is common presentation of Neuromyelitis Optica Spectrum disorder (NMOSD) followed by multiple sclerosis, ADEM and other autoimmune diseases etc. Thus clinically important as it results in severe morbidity and patients are at risk of further attacks. Early diagnosis and confirmation of the underlying cause is vital in order to initiate appropriate therapy and favorable outcomes KEYWORDS: Neuro Myelitis Optica Spectrum disorder (NMOSD), Longitudinally Extensive Transverse Myelitis (LETM), Multiple Sclerosis (MS), Sarcoidosis, lupus

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