Transverse Myelitis

What is Transverse Myelitis?

Transverse myelitis is a neurological condition that creates inflammation in the spinal cord, usually within the protective covering around the nerve cell fibers called the myelin. This inflammation can cause injury to the spinal cord itself, and it might affect what a patient feels in areas of the body below the injury.

Transverse myelitis may also disrupt the transmission of electrical signals to the spinal nerves, leading to various issues with movement and sensory ability.

Several factors have been identified as being responsible for causing the disorder. Some of the more common ones include multiple sclerosis, various viral infections, autoimmune disorders, and vaccinations against infectious diseases. Transverse myelitis has also been associated with Devic’s disease. The condition can affect children and adults of all ages and ethnicities, and there is no clear genetic connection.

What are the Symptoms of Transverse Myelitis?

Transverse myelitis typically appears as a single acute episode.

Symptoms include:

  • Pain in the back or neck
  • Sharp shooting pains in the arms, legs, or abdomen
  • Tingling
  • Numbness
  • Burning sensation
  • Cold feeling
  • Weakness in the extremities
  • Stumbling while walking
  • Heaviness in legs
  • Dragging one foot
  • Paralysis
  • Increased urination
  • Constipation
  • Difficulty urinating
  • Urinary incontinence

In the event that complications linger afterwards, patients might experience debilitating long-term pain, muscle stiffness or tightness, painful spasms, sexual dysfunction, partial or complete paralysis, anxiety, or depression.

Transverse Myelitis Causes

Transverse myelitis can be caused by a number of things, and in many cases, it can be difficult to pinpoint the root cause. It is thought that the condition could be related to abnormal behavior of antibodies throughout the body, which occurs as a result of autoimmune disorders. Over time, these antibodies can cause damage to the spinal cord.

Some of the autoimmune disorders frequently linked with transverse myelitis include:

  • Multiple sclerosis
  • Aquaporin-4 autoantibody-associated neuromyelitis optica
  • Post-infectious or post-vaccine autoimmune phenomenon
  • Abnormal immune system response to underlying cancer

There are also a number of viral infections that can cause transverse myelitis, such as:

  • Varicella-zoster (causes chickenpox and shingles)
  • Herpes simplex
  • Epstein-Barr
  • Flaviviruses (West Nile and Zika)
  • Influenza
  • Echovirus
  • Hepatitis B
  • Tetanus
  • Measles
  • Mumps
  • Rubella
  • Pertussis

Bacteria infections which can cause transverse myelitis include:

  • Syphilis
  • TB
  • Actinomycetes
  • Lyme disease
  • Middle ear infections
  • Bacterial skin infections

The following fungal infections, which occur in the spinal cord, can lead to transverse myelitis:

  • Aspergillus
  • Blastomyces
  • Coccidioides
  • Cryptococcus

Parasites known to cause the condition are:

  • Angtiostrongyloides
  • Cysticercosis
  • Schistosomiasis
  • Toxoplasmosis

Other spiral disorders, such as scleroderma and sarcoidosis, and some vascular disorders, such as disk embolism and arteriovenous malformation, can also cause transverse myelitis.

How is Transverse Myelitis Treated?

Acute transverse myelitis can be treated in a number of different ways. Intravenous steroids can help reduce inflammation. If this is ineffective, plasma exchange therapy may help, although it is not clear why this works for some people.

Antiviral drugs are given to those with a viral infection, while pain medications can alleviate the chronic pain that is often associated with the condition. Other medicines may be prescribed to treat other complications such as bowel or urinary dysfunction. For long-term cases, occupational, physical, and psychotherapy are greatly beneficial.

Transverse Myelitis Prevention

There is no definitive way to prevent transverse myelitis. Since it is often caused by viral infections, vaccination against particularly aggressive or prevalent viruses may be helpful.

Those with preexisting autoimmune disorders or other conditions known to cause transverse myelitis may wish to educate themselves on the symptoms of the condition in order that they can notify their doctor of signs of the illness, who may be able to provide additional treatment.

Successful management and treatment of preexisting conditions are vital for the prevention, or at least for slowing the progression, of transverse myelitis.