Overview
Transverse myelitis is an inflammation of both sides of one section of the spinal cord. This neurological disorder often damages the insulating material covering nerve cell fibers (myelin). Transverse myelitis interrupts the messages that the spinal cord nerves send throughout the body, leading to various symptoms such as pain, muscle weakness, paralysis, sensory problems, or bladder and bowel dysfunction. The causes of transverse myelitis include infections and immune system disorders that attack the body's tissues, as well as other myelin disorders like multiple sclerosis. Treatment involves medications and rehabilitative therapy, and most people with transverse myelitis recover at least partially, although some may experience lingering complications such as pain, stiffness, paralysis, or sexual dysfunction. It is essential to seek medical attention if you experience signs and symptoms of transverse myelitis, as a prompt diagnosis and appropriate treatment are crucial.
Understanding the disease
Symptoms
The symptoms of transverse myelitis may include sudden pain in the lower back that shoots down the legs or arms, abnormal sensations such as numbness, tingling, or burning, weakness in the arms or legs, bladder and bowel problems, and difficulty urinating or constipation.
Risk Factors
Risk factors for developing transverse myelitis may include:
- Infections: Viral, bacterial, and fungal infections can cause transverse myelitis. The inflammatory disorder often appears after recovery from the infection.
- Immune system disorders: Certain immune system disorders, such as multiple sclerosis, may cause transverse myelitis. It's important to note that in many cases, the exact cause of transverse myelitis is not known.
Development
Transverse myelitis can develop due to a variety of causes, including viral infections, bacterial infections, and inflammatory conditions. Viral infections such as herpes viruses, cytomegalovirus, Epstein-Barr, HIV, enteroviruses, West Nile, Echovirus, influenza, and hepatitis B can trigger transverse myelitis. Bacterial infections like Lyme disease, syphilis, tuberculosis, actinomyces, pertussis, tetanus, diphtheria, and certain types of bacterial pneumonia can also cause transverse myelitis. In rare cases, parasites and fungal infections may infect the spinal cord and lead to this disorder. Additionally, transverse myelitis can be caused by autoimmune reactions triggered by various factors, such as other viral infections that don't directly infect the spinal cord. Inflammatory conditions like multiple sclerosis can also contribute to the development of transverse myelitis.
Assessment and Diagnosis
Triage
You should see a doctor if you experience signs and symptoms of transverse myelitis. These symptoms may include pain, muscle weakness, paralysis, sensory problems, or bladder and bowel dysfunction. The symptoms usually develop over a few hours to a few days and may progress gradually over several weeks. Call your doctor or seek emergency medical care if you suspect transverse myelitis, as it is important to receive a prompt diagnosis and appropriate treatment. Other neurological disorders can cause similar symptoms, such as compression of the spinal cord, which is a surgical emergency.
Diagnosis
To diagnose transverse myelitis, a doctor will typically assess your signs and symptoms, medical history, and perform tests to determine inflammation of the spinal cord and rule out other disorders. Some of these tests may include a magnetic resonance imaging (MRI) to visualize the spinal cord and identify inflammation, a lumbar puncture (spinal tap) to examine cerebrospinal fluid, and blood tests to detect infections or antibodies associated with neuromyelitis optica. Early diagnosis and treatment are crucial for the best possible outcome.
Management and Treatment
Complications
Potential complications of transverse myelitis include pain, muscle stiffness or spasms, paralysis of arms or legs, sexual dysfunction, depression or anxiety.
Treatment
Treatment for transverse myelitis typically includes medications and rehabilitative therapy. Medications may be prescribed to reduce inflammation and alleviate symptoms, such as pain or muscle spasticity. Rehabilitative therapy, including physical, occupational, and speech therapy, helps individuals regain strength, mobility, and communication skills. Most people with transverse myelitis recover at least partially, although those with severe attacks may be left with major disabilities.
Preparing for medical consultation
It's important to consult with a healthcare professional for personalized advice on preparing for an appointment related to transverse myelitis.