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Factors associated with functional status at presentation in patients with longitudinally extensive transverse myelitis

Vorasoot N, Saichua P, Sirikarn P, Kasemsap N, Kongbunkiat K, Tiamkao S, Chotmongkol V, Sawanyawisuth K

Orphanet journal of rare diseases, 2025

40 participants

Abstract

Background: Longitudinally extensive transverse myelitis (LETM) is a rare neurological disease. A case series evaluated the predictors of a long-term clinical outcome. However, there is limited data on predictors of functional status at presentation. Therefore, this study aimed to find clinical factors predictive of poor clinical presentation in Asian patients with LETM.

Methods: This was a cross-sectional, retrospective analytical study. The inclusion criteria were adult patients with an age of 18 years or more who met the criteria of LETM. Clinical factors of eligible patients were recorded. Eligible patients were categorized into two groups based on the Expanded Disability Status Scale (EDSS) at the time of presentation; 6 or more vs. 0-5.5. A predictive model for the EDSS score at the time of presentation was created by the logistic regression analysis.

Results: There were 40 patients with LETM in the study. Of those, 31 patients (77.50%) had an EDSS of 6 or more. There were two factors in the model predictive of the EDSS at presentation of 6 or more; thoracic lesion and complete lesion. Only a complete lesion was independently associated with an EDSS at presentation of 6 or more with an adjusted odds ratio of 15.202 (95% confidence interval of 2.028, 113.968; p value = 0.008).

Conclusions: The complete cord lesion was independently associated with severe functional status in patients with LETM at presentation.

How strong is the evidence?

Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health. Reported size: 40 participants or records.

How the five levels of evidence work. The level is assigned automatically from the abstract and can be wrong, so check the paper.

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