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Comparative Study
. 2006 Mar;59(3):566-9.
doi: 10.1002/ana.20770.

Neuromyelitis optica IgG predicts relapse after longitudinally extensive transverse myelitis

Brian G Weinshenker  1 , Dean M Wingerchuk, Sandra Vukusic, Linda Linbo, Sean J Pittock, Claudia F Lucchinetti, Vanda A Lennon
Affiliations
Comparative Study

Neuromyelitis optica IgG predicts relapse after longitudinally extensive transverse myelitis

Brian G Weinshenker et al. Ann Neurol. 2006 Mar.

Abstract

Objective: We investigated whether neuromyelitis optica (NMO) IgG seropositivity at the initial presentation of longitudinally extensive transverse myelitis (LETM) predicts relapse of myelitis or development of optic neuritis.

Methods: Prospective study of patients with initial LETM who were tested for the presence of NMO-IgG.

Results: Eleven of 29 patients (37.9%) were seropositive after a first attack of LETM spanning three or more vertebral segments on magnetic resonance imaging. Of 23 patients followed up for 1 year, none of 14 who were seronegative experienced a relapse or developed optic neuritis. Of 9 seropositive patients, 5 developed a second event: 4 of 9 (44%) developed recurrent transverse myelitis and 1 of 9 (11%) developed optic neuritis (p = 0.004).

Interpretation: LETM represents an inaugural or limited form of NMO in a high proportion of patients. The 40% of patients who are seropositive for NMO-IgG are at high risk for relapse.

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