Transverse myelitis
What is Transverse Myelitis?
Transverse Myelitis (TM) is an inflammatory medical condition in which both sides of the spinal cord are simultaneously inflamed, leading to the disruption of communication between the brain and the body. It is not a single primary disease—rather it can be a symptom or sign of multiple conditions, including multiple sclerosis, lupus, post-infectious complications, vasculitis (inflammation of blood vessels) and tumors.
Symptoms of Transverse Myelitis
Common symptoms of Transverse Myelitis include: severe pain that can be localized to the lower back or midline of the trunk, muscle weakness, difficulty controlling urination or bowel movements, sensory changes, loss of reflexes and abnormal sensation of temperature, burning, stabbing, lewd, numbness or a combination of these symptoms.
Causes of Transverse Myelitis
The causes of TM can be divided into primary and secondary. Primary TM is believed to be due to an autoimmune process in which the body’s own immune system mistakenly attacks healthy tissue. Secondary TM can be caused by certain infections, including viral infections (such as herpes simplex virus, or HSV) or bacterial infections (such as mycoplasma pneumoniae, or MP), as well as certain medical conditions. Other potential causes are radiation exposure, spinal cord trauma, and certain medications.
Diagnosis of Transverse Myelitis
Diagnosis of TM can be challenging, as symptoms may be vague and may mimic those of other neurological conditions. As such, diagnosing TM requires a thoughtful and thorough evaluation. Diagnosis typically involves a physical exam, a review of the patient’s medical history, diagnostic imaging tests (such as an MRI or CT scan), and laboratory tests such as a complete blood count to look for any evidence of infection or autoimmunity.
Treatment of Transverse Myelitis
The treatment of TM depends on the underlying cause. Treatment may involve medications to reduce inflammation, such as corticosteroids or immunosuppressants, and rehabilitation therapies to help restore strength, mobility, physical functioning and quality of life. Physical therapy, occupational therapy and speech and language therapy can be beneficial in restoring muscle and nerve function.
Risks of Transverse Myelitis
Most people who are diagnosed with TM strengthen over time and eventually return to their normal activities. However, there can be long-term complications, such as muscle weakness, pain, urinary and bowel problems, sensory disturbances, psychological problems, fatigue and depression.
Prevention of Transverse Myelitis
While there is no known way to prevent TM, there are a few steps that can be taken to reduce the risk of developing the condition. These include getting vaccinated against certain infections, such as the measles or chickenpox, taking precautions to avoid exposure to infections, and avoiding activities that could lead to spinal cord trauma.
