What are the symptoms of transverse myelitis?

Transverse myelitis is a rare neurological condition characterized by inflammation of the spinal cord. The inflammation can damage the myelin (the protective covering of nerve fibers) and the nerve fibers themselves, leading to a range of symptoms. The symptoms of transverse myelitis can develop rapidly or gradually over hours to days. Common symptoms include:

1. Back pain: Pain in the lower back is often the first symptom of transverse myelitis, which can be sharp, stabbing, or burning in nature.
2. Muscle weakness: Weakness or paralysis of the legs or arms can occur, which may lead to difficulty walking or performing tasks that require fine motor skills.
3. Sensory disturbances: Sensory symptoms are common and can include numbness, tingling, or a “pins and needles” sensation in the legs, feet, arms, or hands.
4. Bowel and bladder dysfunction: Transverse myelitis can affect the nerves that control bowel and bladder function, leading to symptoms such as urinary urgency, urinary retention, constipation, or incontinence in men and incontinence in women.
5. Fatigue: Many people with transverse myelitis experience fatigue, which can be debilitating and affect daily activities.
6. Spasticity: Muscle stiffness or spasms can occur, especially in the legs.
7. Changes in reflexes: Reflexes may be exaggerated (hyperreflexia) or diminished (hyporeflexia) compared to normal.
8. Difficulty with coordination: Some individuals may experience difficulty with balance and coordination.
9. Pain: Some people with transverse myelitis may experience neuropathic pain, which is a chronic, burning, or shooting pain that can be difficult to treat.

The severity and duration of symptoms can vary widely among individuals with transverse myelitis. In some cases, symptoms may improve or resolve partially over time, while in others, they may be permanent. Early diagnosis and treatment by a healthcare provider are important to help manage symptoms and prevent complications.

What are the causes of transverse myelitis?

Transverse myelitis is believed to be an autoimmune disorder, which means that the body’s immune system mistakenly attacks the healthy tissues of the spinal cord, leading to inflammation and damage. However, the exact cause of the immune system dysfunction in transverse myelitis is not fully understood. Several factors may contribute to the development of transverse myelitis, including:

1. Infections: Viral infections, such as herpes simplex, varicella-zoster (chickenpox and shingles), Epstein-Barr, cytomegalovirus, and human immunodeficiency virus (HIV), have been associated with transverse myelitis. Bacterial infections, such as tuberculosis and syphilis, can also be potential triggers.
2. Immune system disorders: Conditions that affect the immune system, such as multiple sclerosis, neuromyelitis optica, and systemic lupus erythematosus, can increase the risk of developing transverse myelitis.
3. Vaccinations: In rare cases, certain vaccinations, such as those for measles, mumps, rubella, and influenza, have been associated with the development of transverse myelitis.
4. Other inflammatory disorders: Conditions that cause inflammation in the body, such as sarcoidosis and Behçet’s disease, may increase the risk of transverse myelitis.
5. Vascular disorders: Blood vessel disorders, such as vasculitis, can lead to decreased blood flow to the spinal cord, which can trigger inflammation.
6. Environmental factors: Exposure to certain environmental toxins or chemicals may increase the risk of developing transverse myelitis, although specific triggers have not been identified.

It’s important to note that while these factors may increase the risk of developing transverse myelitis, not everyone exposed to these factors will develop the condition. Transverse myelitis is considered a rare disorder, and most cases occur sporadically without an identifiable cause.

What is the treatment for transverse myelitis?

The treatment for transverse myelitis aims to reduce inflammation, manage symptoms, prevent complications, and promote recovery. Treatment may include:

1. Corticosteroids: Corticosteroids, such as prednisone or methylprednisolone, are often used to reduce inflammation in the spinal cord. These medications are usually given intravenously (IV) in high doses initially, followed by a tapering dose over time.
2. Plasma exchange (plasmapheresis): Plasma exchange may be used in cases where corticosteroids are not effective. This procedure involves removing blood from the body, separating the plasma (which contains antibodies) from the blood cells, and then returning the blood cells to the body. This can help remove harmful antibodies and other proteins that may be contributing to the inflammation.
3. Intravenous immunoglobulin (IVIG): IVIG is a treatment that involves giving high doses of antibodies from donated blood to help modulate the immune response. IVIG may be used in cases where corticosteroids and plasma exchange are not effective.
4. Pain management: Medications may be prescribed to help manage pain associated with transverse myelitis, such as nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, anticonvulsants, or antidepressants.
5. Physical therapy: Physical therapy can help improve muscle strength, flexibility, and mobility, as well as prevent complications such as muscle contractures and joint stiffness.
6. Occupational therapy: Occupational therapy can help individuals learn new ways to perform daily activities and improve their independence.
7. Treatment of underlying conditions: If transverse myelitis is caused by an underlying condition, such as an infection or autoimmune disorder, treatment of the underlying condition may be necessary.

The specific treatment plan for transverse myelitis will depend on the underlying cause, the severity of symptoms, and the individual’s overall health. It’s important for individuals with transverse myelitis to work closely with a healthcare team to develop a personalized treatment plan. Early diagnosis and treatment are crucial for managing the condition and improving outcomes.