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AKU Student

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Document Type

Original Article

Abstract

Background and Objective: Acute transverse myelitis (ATM) is an inflammatory spinal cord disorder presenting with motor, sensory, and autonomic dysfunction. The objective of this study was to assess the prognostic value of spinal MRI findings and treatment timing in predicting neurological outcomes in patients with acute transverse myelitis.

Methods: A retrospective analysis was conducted on 90 patients diagnosed with ATM at Chandka Medical College Hospital, Larkana, between January 2021 and December 2023. All patients underwent spinal MRI at presentation, and imaging characteristics—including lesion location, longitudinal extent, and enhancement pattern—were recorded. Clinical outcomes were assessed at one month, three months, and one year using the Modified Rankin Scale (mRS) and the ASIA Impairment Scale (AIS). Statistical tests evaluated associations between MRI findings, treatment timing, and recovery patterns.

Results: The mean age was 41.5 ± 5 years; 54 patients (60%) were male. MRI revealed normal findings in 20 patients (22.2%) and abnormalities in 70 (77.8%). Overall, 20 patients (22.2%) achieved full recovery, 52 (57.7%) showed partial improvement, and 18 (20%) had no recovery. Normal MRI strongly predicted favorable outcomes (85% full recovery; p < 0.0001). Early treatment (≤3 days) significantly improved recovery rates (33.3% vs. 11.5%; p = 0.0088).

Conclusion: MRI characteristics and early therapeutic intervention are key predictors of neurological recovery in ATM. Normal MRI findings and prompt treatment initiation were associated with significantly better outcomes, emphasizing the importance of early imaging and rapid management to reduce long-term disability.

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