Transverse Myelitis

Transverse Myelitis

Overview

Transverse myelitis is a disorder characterised by inflammation of the spinal cord. Usually, both sides of the same section of the spinal cord become inflamed. The neurological disorder damages the myelin sheath, which is the insulating protective layer of the nerve cell. This interrupts the electrical signals sent from the spinal cord to the rest of the body, resulting in sensory problems, bowel and bladder dysfunction, muscle weakness, or paralysis. Transverse myelitis could be caused by infections or auto-immune disorders.

Signs and symptoms

Transverse myelitis may cause symptoms below the affected part of the spine, on one side or both sides of the body. These include shooting pains in the lower back, abdomen, chest, arms or legs. Some patients also experience numbness and tingling in various parts of the body, distorted sensation of cold or hot, severe muscle weakness and sensitivity to light. Patients usually experience bowel and bladder control problems as a result of nerve dysfunction below the waist. This includes retention of urine frequent urination, urinary incontinence and constipation.

Causes

The exact cause of transverse myelitis is unknown but it appears to be triggered by an infection or an auto-immune condition. Viral, bacterial and fungal infections in the body could trigger the inflammation that target the spinal cord. Bacterial skin infections and gastrointestinal infections also appear to trigger the condition. A number of other neurological conditions like multiple sclerosis, neuromyelitis optica or sarcoidosis could also lead to transverse myelitis.

Risk factors

Transverse myelitis can occur in patients of any age. Patients with multiple sclerosis or neuromyelitis optica are at a higher risk of developing transverse myelitis.

Complications

Patients with post infectious transverse myelitis usually only experience one episode. But patients with autoimmune background tend to have a relapsing transverse myelitis picture. Patients who recover often experience complications such as chronic pain, muscle spasms, partial or total paralysis, sexual dysfunction, depression or anxiety.

Diagnosis

The physician first reviews the patient’s medical history and performs a physical and neurological exam. The doctor will also require an MRI scan and a CT scan to visualise the extent of inflammation and damage. A panel of blood tests and a spinal tap may also be required to check for infections or evidence of antibodies from an auto-immune attack.

Treatment

Recovery from transverse myelitis can be hastened by immunotherapetics like steroids, plasma exchange or cyclophosphamide. Symptomatic therapy for the complications include pain medication and other medicines for relief of muscle spasms, depression and bowel dysfunction. If the doctor suspects that the transverse myelitis is caused by a viral infection, they may treat it with antiviral drugs. The patient may also be recommended physical therapy to regain muscle strength and co-ordination.

Prevention

As the exact cause of transverse myelitis is unknown, it cannot be prevented.

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