Author Of 1 Presentation
P0568 - Disappearance of spinal cord lesions in multiple sclerosis. A longitudinal study of 8
patients. (ID 119)
Abstract
Background
Multiple sclerosis (MS) is a chronic, immune-mediated demyelinating disease of the central nervous system. Up to 90% of MS patients have spinal cord hyperintensities seen on MRI. The spinal cord is one of four anatomical locations integrated into the 2017 McDonald diagnostic criteria, allowing spatial dissemination.
Objectives
The main objective of this study is to describe a group of MS patients with disappearing of initial spinal cord lesions.
Methods
We performed a retrospective study of MS patients followed in Montpellier University Hospital between 2015 and 2019. All the patients with an acute partial transverse myelitis and no spinal cord lesion identified on follow-up MRI were recorded. MRI sequences were: Sagittal T1 TSE; Sagittal T1 TSE gado; Sagittal T2; Sagittal T2 TSE; T2 AX; Sagittal T2 STIR.
Results
Among 2700 MS patients, 8 cases had initial spinal cord lesions, not found on serial MRI. Clinical features of these patients were: sex ratio F/M – 4:1; mean age of onset 32,8 (±17,3) years. At last clinical evaluation (duration of follow-up: 60,7 ±55,3 months) mean EDSS was 0.75 (±0,89). All the patients had cervical or dorsal acute partial transverse myelitis with dorsal and lateral localizations. On the control MRI, spinal cord hyperintensities were no longer present using sagittal and axial STIR and T2 sequences.
Conclusions
This study shows that spinal cord lesions can disappear over time. These features could be explained by transient demyelination, oedema without any demyelination. Since MR sequences were identical in all MS patients, false negative could be unlikely.