Characteristics of acute transverse myelitis at Aga Khan University Hospital, Karachi

Objective: To determine the presenting features and etiological classification of acute transverse myelitis (ATM) at Aga Khan University Hospital, a tertiary care hospital in Pakistan. Methods: Twenty consecutive patients of ATM (1990-2003) fulfilling a preset criterion were analyzed for demographic features, clinical presentation, laboratory investigations and neuro-imaging. Results: Half of the patients were males and their median age was 29 years (range 6-73 years). Fever, paraparesis, quadri-paresis and bladder dysfunction were the most common presentations. Median score on disability rating scale (DRS) was twelve. Sixty percent of the patients were classified as Idiopathic-ATM while 30% and 10% as Para infectious associated-ATM and Multiple sclerosis associated-ATM respectively. Conclusion: Idiopathic acute transverse myelitis is the most common type of ATM in the studied population. Our data suggested that the severity of motor impairment is greater in our population than that reported in western literature which might hint to different genetic or environmental etiological factors involved in the pathogenesis of acute transverse myelitis.