Neurological and functional recovery in acute transverse myelitis patients with inpatient rehabilitation and magnetic resonance imaging correlates

Abstract

Objective: The objective of this study was to observe neurological and functional recovery in patients with acute transverse myelitis (ATM) with inpatient rehabilitation and correlate with magnetic resonance imaging (MRI) changes. Patients and Methods: The study was conducted with 43 ATM patients (19 males) admitted in the tertiary university research hospital from July 2012 to June 2014. Detailed MRI findings were noted. Neurological status was assessed using the ASIA impairment scale (AIS) and functional recovery was assessed using the Barthel Index score (BI) and Spinal Cord Independence Measure (SCIM). Results: Patients showed significant neurological and functional recovery with inpatient rehabilitation using AIS, BI and SCIM scales when admission and discharge scores were compared (P<0.001). Thirty-one patients (72.1%) had rostral level in the cervical region according to MR imaging, but clinically, 17 patients had tetraplegia, whereas 26 patients had lower-limb weakness only. No definitive pattern or correlation was found between level (MRI or clinical) and neurological status (AIS). Conclusion: The neurological outcome in patients with ATM cannot be predicted on the basis of imaging findings. There is a great variation in the imaging level and clinical presentation. Patients show significant improvement with inpatient rehabilitation even with poor functional ability in acute and sub-acute phase of illness.