Faculty Bibliography

Objective: To assess the relationship between etiologyand functional outcome in 7 cases of transverse myelitis after acute inpatient rehabilitation. Design: Retrospective review of 7 cases of transverse myelitis. Setting: Inpatient rehabilitation facility. Participants: One male and 6 female patients, admitted from January 2007 to June 2009, were identified with acute transverse myelitis. Results: Two of the patients were positive for anti-NMO (neuromyelitis optica), one had positive herpes antibody, and the rest were idiopathic. All 7 patients were initially treated with intravenous steroids before admission to our rehabilitation facility. Some of those patients also received IVIG, plasmapheresis, or mitoxantrone. Two patients had multiple recurrences. Their functional outcomes were assessed by using Functional Independence Measure (FIM) score upon admission and at discharge. Discussion: Transverse myelitis is a neurologic condition that affects function of the spinal cord with no history of trauma. Most cases are idiopathic and presumably secondary to autoimmune origin. Multiple diseases can be related to this condition, including NMO, SLE, antiphospholipid antibody syndrome, mixed connective tissue disease, CNS sarcoidosis, and infectious disease (herpes zoster). We reviewed the rehabilitation outcome of patients with acute transverse myelitis by comparing their FIM scores upon admission and at discharge. Conclusions: There is limited literature available that has reported functional outcomes among this population. The patients reviewed on this study had different spinal cord levels of a lesion, and their changes with the FIM score appear to be independent from etiology. There was a significant improvement on the functional status of all the patients after participating on acute inpatient rehabilitation, as per preliminary analysis of the FIM scores on admission and discharge. Successful management of patients with acute transverse myelitis is associated with understanding of its pathophysiology and prevention of secondary complication as well as utilization of all rehabilitation disciplines