Neuromyelitis optica IgG predicts relapse after longitudinally extensive transverse myelitis

Ann Neurol. 2006 Mar;59(3):566-9. doi: 10.1002/ana.20770.


Objective: We investigated whether neuromyelitis optica (NMO) IgG seropositivity at the initial presentation of longitudinally extensive transverse myelitis (LETM) predicts relapse of myelitis or development of optic neuritis.

Methods: Prospective study of patients with initial LETM who were tested for the presence of NMO-IgG.

Results: Eleven of 29 patients (37.9%) were seropositive after a first attack of LETM spanning three or more vertebral segments on magnetic resonance imaging. Of 23 patients followed up for 1 year, none of 14 who were seronegative experienced a relapse or developed optic neuritis. Of 9 seropositive patients, 5 developed a second event: 4 of 9 (44%) developed recurrent transverse myelitis and 1 of 9 (11%) developed optic neuritis (p = 0.004).

Interpretation: LETM represents an inaugural or limited form of NMO in a high proportion of patients. The 40% of patients who are seropositive for NMO-IgG are at high risk for relapse.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Biomarkers / blood
  • Chi-Square Distribution
  • Female
  • Follow-Up Studies
  • Humans
  • Immunoglobulin G / blood*
  • Magnetic Resonance Imaging / methods
  • Male
  • Middle Aged
  • Myelitis, Transverse / cerebrospinal fluid
  • Myelitis, Transverse / complications*
  • Myelitis, Transverse / pathology
  • Neuromyelitis Optica / blood
  • Neuromyelitis Optica / immunology*
  • Predictive Value of Tests
  • Prospective Studies
  • Recurrence
  • Retrospective Studies
  • Serologic Tests / methods
  • Statistics, Nonparametric


  • Biomarkers
  • Immunoglobulin G