Clinical characteristics of ultra-longitudinally extensive transverse myelitis in a Peruvian cohort

Introduction: Ultra-longitudinally extensive transverse myelitis (uLETM) is defined as an inflammatory lesion involving 10 or more spinal cord segments. The aim of our study is to describe the clinical and radiological features of this atypical form of myelitis. Methods: We conducted a descriptive cross-sectional study of clinical data from 57 patients older than 18 years diagnosed with longitudinally extensive transverse myelitis. Nineteen cases were classified as uLETM. Results: Twelve of the 19 patients were women, age ranged between 18 and 76 years, and the main aetiology was neuromyelitis optica spectrum disorder (8 patients), followed by anti-MOG antibody myelitis (3 patients). The main region involved was at cervical-thoracic spinal cord. Two patients presented complete spinal cord lesion. Conclusions: Our results are consistent with previous reports suggesting that neuromyelitis optica spectrum disorder remains the main aetiology in uLETM; however, anti-MOG antibodies should be considered within the differential diagnosis.