Journal article
Evidence-based guideline: Clinical evaluation and treatment of transverse myelitis Report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology
Neurology, v 77(24), pp 2128-2134
01 Dec 2011
PMID: 22156988
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Objective: To assess the evidence for diagnostic tests and therapies for transverse myelitis (TM) and make evidence-based recommendations.
Methods: A review of the published literature from 1966 to March 2009 was performed, with evidence-based classification of relevant articles.
Recommendations: Level B recommendations: neuromyelitis optica (NMO)-immunoglobulin G (IgG) antibodies should be considered useful to determine TM cause in patients presenting with clinical acute complete transverse myelitis (ACTM) features. The presence of NMO-IgG antibodies (aquaporin-4-specific antibodies) should be considered useful in determining increased TM recurrence risk. Level C recommendations: in suspected TM, distinction between ACTM or acute partial transverse myelitis may be considered useful to determine TM etiology and risk for relapse (more common with APTM). Age and gender may be considered useful to determine etiology in patients presenting with TM syndrome, with spinal infarcts seen more often in older patients and more female than male patients having TM due to multiple sclerosis (MS). Brain MRI characteristics consistent with those of MS may be considered useful to predict conversion to MS after a first partial TM episode. Longer spinal lesions extending over >3 vertebral segments may be considered useful in determining NMO vs MS. CSF examination for cells and oligoclonal bands may be considered useful to determine the cause of the TM syndrome. Plasma exchange may be considered in patients with TM who fail to improve after corticosteroid treatment. Rituximab may be considered in patients with TM due to NMO to decrease the number of relapses. Level U recommendations: there is insufficient evidence to support or refute the efficacy of other TM therapies or the usefulness of ethnicity to determine the cause of a subacute myelopathy. Neurology (R) 2011; 77: 2128-2134
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Details
- Title
- Evidence-based guideline: Clinical evaluation and treatment of transverse myelitis Report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology
- Creators
- T. F. Scott - Drexel UniversityE. M. Frohman - OphthalmologyJ. De Seze - University of StrasbourgG. S. Gronseth - University of KansasB. G. Weinshenker - Mayo Clinic Rochester, MNTherapeutics and Technology Assessment Subcommittee of American Academy of Neurology
- Publication Details
- Neurology, v 77(24), pp 2128-2134
- Publisher
- Lippincott Williams & Wilkins
- Number of pages
- 7
- Grant note
- Acorda Therapeutics Inc. Avanir Pharmaceuticals Teva Pharmaceutical Industries Ltd.; Teva Pharmaceutical Industries Genzyme Corporation; Sanofi-Aventis Novartis Guthy-Jackson Charitable Foundation RSR Ltd.; RSR LTD Bayer Schering Pharma; Bayer AG Pittsburgh Foundation National Multiple Sclerosis Society Abbott; Abbott Laboratories American Academy of Neurology Biogen Idec; Biogen
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Neurology
- Web of Science ID
- WOS:000298323500017
- Scopus ID
- 2-s2.0-84856155835
- Other Identifier
- 991019167675304721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Clinical Neurology