PracticeUpdate: Neurology - Winter 2018

CONFERENCE COVERAGE 20

International Congress on Neuromuscular Diseases 2018

6–10 JULY 2018 • VIENNA, AUSTRIA By the PracticeUpdate Editorial Team

© TIRZA/www.tirza.at

Transcranial Magnetic Stimulation Can Help Diagnose and Prognose ChildrenWith Sequelae of Acute TransverseMyelitis Transcranial magnetic stimulation is shown to detect neurophysiologic changes of acute transverse myelitis in 96% of cases T ranscranial magnetic stimulation has been shown to be help- ful in diagnosing and prognosing children with sequelae of acute transverse myelitis, show results of a comparative study reported at ICNMD 2018. In four cases, lesion location was cervical; in seven, thoracic; and in thirteen, lumbar. Lesion etiology was enterovirus (n=20) and Epstein-Barr virus (n=4).

A total of 18 children were unable to walk, lower paresis was seen in the other 6 cases. Ventilation was not required in any cases. Single-pulse transcranial magnetic stimulation was employed. A Neiro-MS D magnetic stimulator was used. A total of three neurophysiologic patterns were observed in the myelitis group: • The presence of both cortical (though disperse and low-ampli- tude) and spinal motor-evoked potentials (n=15) • The presence of spinal only, without cortical motor-evoked potentials (n=6) • The total absence of both spinal and cortical motor-evoked potentials (n=3) During the 2 to 5 year follow-up period, 10 children (42%) were unable to walk 50 m and required a walker, 11 (46%) exhibited nor- mal motor function, and 3 (13%) suffered from total paraplegia with no lower limb movement, and no sign of recovery.

Dr. Vladislav B. Voitenkov Vladislav B. Voitenkov, MD, PhD, of the Pedi- atric Research and Clinical Center for Infectious Diseases in Saint Petersburg, Rus- sian Federation, and colleagues evaluated motor pathways in children with viral myelitis using transcranial magnetic stimulation. Dr. Voitenkov explained to Elsevier’s Prac- ticeUpdate , “Since transverse myelitis is devastating and highly disabling, and requires long and costly rehabilitation inter- ventions, it is essential to be able to predict the efficacy of these interventions.” A total of 20 healthy children (7 to 14 years, average 12 years of age) without signs of spinal disorders were enrolled as controls. The main group consisted of 24 individuals (8 to 16 years, average 11 years of age) with acute viral transverse myelitis.

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