Epidemiology

The epidemiology of transverse myelitis (TM) depends on its underlying cause. The annual incidence of idiopathic complete TM is uncertain as most studies precede the discovery of the aquaporin-4-IgG and myelin oligodendrocyte glycoprotein-IgG autoantibodies. These autoantibodies have provided a definable etiology for some TM cases previously thought to be idiopathic.[10][11] One 2021 retrospective review using the National US Veterans Health Administration database from 1999 to 2015 showed a point prevalence of 7.86 cases of TM per 100,000 people. Of the 961 patients, 31.8% of them were diagnosed with disease-associated TM and 68.2% were diagnosed with idiopathic TM.[12]

Acute partial TM commonly heralds or accompanies multiple sclerosis (MS), which affects up to 0.3% of people of Northern European ancestry.[13]

The pattern of longitudinally extensive TM is commonly associated with neuromyelitis optica spectrum disorder (NMOSD), which may account for approximately 1% of all central nervous system demyelinating disease in North American and European populations, a somewhat greater proportion in African-American and Hispanic populations, up to 30% in the Japanese population, and virtually all cases in ethnic or racial groups in which typical MS is virtually absent, such as aboriginal peoples of North America and black Africans.[9][14]

Onset may occur at any age. MS-associated cases typically occur between ages 20 and 50 years (median about 29 years) whereas the median onset age for NMOSD cases is about a decade later.[4][13] There is a female predominance in all subtypes.[12]​ These syndromes also affect children, although the incidence is unknown. The treatment of TM in children is usually the same as in adults.[15][16][17]

The epidemiology of other infectious and inflammatory myelopathies varies depending on the underlying etiology.

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