Background
Acute transverse myelitis(ATM) is a group of disorders characterized by focal inflammation of the spinal cord and resultant neural injury. It can be diagnosed by Transverse Myelitis Consortium WorkingGroup(TMCWG) criteria. But there are some cases which were not satisfied with idiopathic ATM criteria, both clinically and radiologically, especially in acute stage. So we analyzed 27 cases retrospectively, which were diagnosed as idiopathic ATM.
Methods
All the records of the patients at Gil Medical Center with a diagnosis of idiopathic ATM from 2001 to 2005 were reviewed. And clinical manifestations including neurological examination, radiologic features and cerebrospinal fluid (CSF) findings were analyzed.
Results
Among the patients(20 men and 7 women; mean age, 45.3 years), 11 cases could not be diagnosed as idiopathic ATM according to the TMCWG criteria ; 6 cases did not have well marginated upper sensory level and 5 cases were not satisfied with spinal cord inflammation.
Conclusions
Although most cases of suspected idiopathic ATM were suitable for TMCWG criteria, some cases were not satisfied with this diagnostic criteria, especially in acute stage. Subsequent study might be needed to evaluate the reliability and clinical application of the criteria.

Guillain-Barr?syndrome(GBS) is a common demyelination disease of the peripheral nervous system. But recently, the axonal types are also reported. Acute transverse myelitis(ATM) is also a common inflammatory disease of the spinal cord. Generally, it is difficult to identify the etiology of GBS and ATM. I guess the occurrence of the 2 disease at once is hard to take the plase. A 63-years-old woman showed an acute motor axonal GBS and a cervival-upper thoracic ATM occurring at the same time. she ws treated by intravenous immunoglobulin and solumedrol therapy. Her sensory symptoms were improved rapidly but motor symptoms showed only mild improvement.