Transverse Myelitis

1 What is Transverse Myelitis?

Transverse myelitis is a condition in which there is inflammation of spinal cord. The covering called myelin is often targeted in this case. It results in injury across the spinal cord affecting sensation below the injury.

There is disruption in the transmission of signals causing pain or other sensory problems, weakness or paralysis of muscles, or bladder and bowel dysfunction there are several factors like infections and immune system disorders which can cause this disorder.

Treatment for transverse myelitis and rehabilitative therapy. Most people with transverse myelitis recover partially but major disabilities may occur.

2 Symptoms

Signs and symptoms of transverse myelitis typically include:

  • Pain- in the neck and back depending on the part of spinal cord affected. Pain may radiate down to the legs or arms or around abdomen.
  • Abnormal sensations- people often experience sensations of numbness, tingling, coldness or burning. People may feel like something is tightly wrapping the skin of the chest, abdomen or legs.
  • Weakness in arms or legs- people may experience mild weakness as if they are stumbling or dragging one foot or that their legs feel heavy as they move.
  • Bladder and bowel problems- these problems include an increased urinary urge, urinary incontinence, difficulty urinating and constipation.
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3 Causes

The exact cause of transverse myelitis is unknown however, certain conditions may be associated with the disorders including: viral and other infections or respiratory or GIT have been implicated in transverse myelitis.

The viruses that can infect spinal cord include herpes virus and west Nile virus. Multiple sclerosis is a disorder in which the immune system destroys the covering of spinal cord and meninges.

Neuromyelitis optica is a condition in which there is inflammation or loss of myelin around the spinal cord and the nerve in the eye that transmits information to brain. Autoimmune disorders affecting body systems may contribute to transverse myelitis. Such disorders include systemic lupus erythematosus and Sjogren’s syndrome.

Vaccinations for infectious diseases like hepatitis B, MMR (measles, mumps and rubella) and DPT (diphtheria and tetanus) can act as possible triggers.

4 Making a Diagnosis

The diagnosis of transverse myelitis is based on medical history, physical examination, nerve function assessment, and results of tests.

The following tests are recommended to rule out other disorders:

  • MRI- electromagnetic waves are used to create cross sectional images of soft tissues. It has the potential to identify causes of symptoms including abnormalities causing spinal cord compression and blood vessel malformations.
  • Lumbar puncture- in this procedure a needle is used to draw CSF (cerebrospinal fluid) from the spinal column.
  • Blood tests- it includes a test that checks for antibodies associated with neuromyelitis optica and other conditions.

5 Treatment

Several treatments for transverse myelitis targeting the signs and symptoms are available:

  • Drug therapy. Intravenous steroids- the patient is likely to receive steroids through a vein in the arm over the course of several days. These steroids help to reduce the inflammation in the spinal cord.
  • Plasma exchange therapy. People who don’t respond to intravenous steroids undergo this therapy which involves removing the plasma and replacing it with special fluids.
  • Antiviral medications- these are given to those patients who have viral infections of spinal cord.
  • Pain medications. Common pain medications including Acetaminophen, Ibuprofen and naproxen sodium are given for chronic pain. medications to treat other complications- certain other medication maybe required to treat problems like muscle spasticity, urinary or bowel dysfunction, depression or other complications associated with transverse myelitis.
  • Medications to prevent recurrent attacks of transverse myelitis- some people may require ongoing immunosuppressive mechanisms such as corticosteroids to reduce recurrent attacks of transverse attacks of transverse myelitis.
  • Nondrug therapy. Physical therapy- it helps to improve strength and coordination. Occupational therapy- this allows people with transverse myelitis to learn new ways of performing day to day activities such as bathing, preparing a meal and house cleaning.
  • Psychotherapy- a psychotherapist uses talk therapy to treat anxiety and depression.

6 Prevention

No preventive measures exist for transverse myelitis.

7 Alternative and Homeopathic Remedies

No alternatives or homeopathic remedies can treat transverse myelitis.

8 Lifestyle and Coping

Lifestyle modifications are necessary in order to cope with transverse myelitis.

The diagnosis of transverse myelitis may be overwhelming for some people and therefore coping with it becomes difficult.

People should talk with counsellors which will help them to get rid of anxiety, depression, sexual dysfunction and other emotional or behavioral issues. Although most people with transverse myelitis have partial recovery the process takes at least a year or more.

People are left with following after treatment:

  • no or slight disability, in which people experience minimal symptoms.
  • moderate disability in which people are mobile but may have difficulty walking numbness or tingling and bladder or bowel problems.
  • severe disability includes those people who need a wheel chair and require ongoing assistance.

9 Risks and Complications

Some complications of transverse myelitis often linger including the following:

  • chronic pain,
  • muscle spasticity,
  • partial or total paralysis,
  • sexual dysfunction,
  • depression or anxiety.
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