@article{6d8a0e34fde34cf38eb2822f53d83722,
title = "Evidence-based guideline: Clinical evaluation and treatment of transverse myelitis: Report of the therapeutics and technology assessment subcommittee of the American Academy of Neurology",
abstract = "Objective: To assess the evidence for diagnostic tests and therapies for transverse myelitis (TM) and make evidence-based recommendations. Methods: A review of the published literature from 1966 to March 2009 was performed, with evidence-based classification of relevant articles. Recommendations: Level B recommendations: neuromyelitis optica (NMO)-immunoglobulin G (IgG) antibodies should be considered useful to determine TM cause in patients presenting with clinica acute complete transverse myelitis (ACTM) features. The presence of NMO-IgG antibodies (aquaporin-4-specific antibodies) should be considered useful in determining increased TM recurrence risk. Level C recommendations: in suspected TM, distinction between ACTM or acute partial transverse myelitis may be considered useful to determine TM etiology and risk for relapse (more common with APTM). Age and gender may be considered useful to determine etiology in patients presenting with TM syndrome, with spinal infarcts seen more often in older patients and more female than male patients having TM due to multiple sclerosis (MS). Brain MRI characteristics consistent with those of MS may be considered useful to predict conversion to MS after a first partial TM episode. Longer spinal lesions extending over >3 vertebral segments may be considered useful in determining NMO vs MS. CSF examination for cells and oligoclonal bands may be considered useful to determine the cause of the TM syndrome. Plasma exchange may be considered in patients with TM who fail to mprove after corticosteroid treatment. Rituximab may be considered in patients with TM due to NMO to decrease the number of relapses. Level U recommendations: there is insufficient evidence to support or refute the efficacy of other TM therapies or the usefulness of ethnicity to determine the cause of a subacute myelopathy.",
author = "Scott, {T. F.} and Frohman, {E. M.} and {De Seze}, J. and Gronseth, {G. S.} and Weinshenker, {B. G.}",
note = "Funding Information: Study funding: This evidence-based guideline was funded by the American Academy of Neurology. No author received honoraria or financial support to develop this document. Funding Information: Dr. Scott has received funding for travel or speaker honoraria from, served on the speakers' bureaus and scientific advisory boards of, and performed consultation work for Acorda Therapeutics Inc., Avanir Pharmaceuticals, Biogen Idec, Novartis, and Teva Pharmaceutical Industries Ltd.; served as an associate editor for BMC Neurology; and has received research support from Biogen Idec, National Multiple Sclerosis Society, Novartis, Pittsburgh Foundation, and Teva Pharmaceutical Industries Ltd. Dr. Frohman has received funding for travel and/or speaker honoraria from Biogen Idec, Teva Pharmaceutical Industries Ltd., Genzyme Corporation, Abbott, Acorda Therapeutics Inc., and Bayer Schering Pharma; has served on speakers' bureaus for Biogen Idec, Teva Pharmaceutical Industries Ltd., Bayer Schering Pharma, and Athena Diagnostics; and has served as a consultant for Biogen Idec, Teva Pharmaceutical Industries Ltd., Athena Diagnostics, Inc., Acorda Therapeutics Inc., and Abbott. Dr. de Seze serves on scientific advisory boards for and has received honoraria from Biogen Idec, LFB, Merck Serono, sanofi-aventis, and Bayer Schering Pharma; and serves on the editorial board of Revue Neurologique. Dr. Gronseth serves as an editorial advisory board member of Neurology Now, serves on a speakers' bureau for Boehringer Ingelheim, and receives honoraria from Boehringer Ingelheim and the American Academy of Neurology. Dr. Weinshenker serves on data safety monitoring boards for Novartis and Biogen Idec; serves on the editorial boards of the Canadian Journal of Neurological Sciences, the Turkish Journal of Neurology, and Multiple Sclerosis; has received research support from Genzyme Corporation and the Guthy-Jackson Charitable Foundation; and receives license royalties from RSR Ltd. for a patent re: Aquaporin-4 associated antibodies for diagnosis of neuromyelitis optica. ",
year = "2011",
month = dec,
day = "13",
doi = "10.1212/WNL.0b013e31823dc535",
language = "English (US)",
volume = "77",
pages = "2128--2134",
journal = "Neurology",
issn = "0028-3878",
publisher = "Lippincott Williams and Wilkins",
number = "24",
}