Transverse Myelitis

Transverse myelitis is a condition where the spinal cord, which is like a pathway for messages between your brain and body, becomes inflamed on both sides in one area. This inflammation often damages the protective covering around the nerves (myelin), which is like the insulation on electrical wires.

When the myelin is damaged, the messages traveling along the spinal cord nerves can't get through properly. This can lead to a range of problems. For example, you might experience pain, weakness in your muscles, loss of ability to move (paralysis), problems with sensation (like feeling touch or temperature), or trouble controlling your bladder or bowels.

There are many things that can cause transverse myelitis. Some causes are infections, like viruses or bacteria, and problems with the body's immune system where it mistakenly attacks its own tissues. Other possible causes include other conditions that affect the myelin sheath, such as multiple sclerosis. Sometimes, conditions like a stroke affecting the spinal cord can have similar symptoms, but they require different treatment. It's important to get a proper diagnosis to know the exact cause.

Treatment for transverse myelitis often involves medications to manage the inflammation and supportive therapies to help with recovery. Physical therapy, occupational therapy, and speech therapy can all be helpful. Many people with transverse myelitis recover some or even most of their abilities. However, in severe cases, the condition can lead to lasting disabilities.

Transverse myelitis is a condition that affects the spinal cord. Symptoms usually appear over a short period, sometimes a few hours or days, but occasionally they develop more slowly, over several weeks.

The condition typically affects both sides of the body below the area of the spinal cord that's damaged, though sometimes symptoms are only on one side.

Common signs and symptoms include:

• Pain: Transverse myelitis pain often starts suddenly in the lower back. It can feel like sharp pain shooting down the legs, arms, or around the chest or stomach. Exactly where the pain is and how intense it is depends on which part of the spinal cord is affected.

• Strange sensations: Many people experience unusual feelings like numbness, tingling, coldness, or burning sensations. Some people are overly sensitive to light touch, heat, or cold. They might feel like something is constricting or wrapping around their chest, stomach, or legs.

• Muscle weakness: People may notice their legs feeling heavy or that they're tripping or dragging a foot. In severe cases, weakness progresses to complete paralysis in the affected limbs.

• Problems with bladder and bowel function: This can include needing to urinate more often, leaking urine (incontinence), trouble urinating, or constipation. These issues are a common part of transverse myelitis.

If you have symptoms of transverse myelitis, see a doctor right away or get emergency medical help. Transverse myelitis is a condition that affects the spinal cord, causing problems with sensation, movement, and bladder/bowel control. Several things can cause these issues, including pressure on the spinal cord. This type of pressure is a serious medical emergency that needs immediate attention, often requiring surgery.

Another reason for these symptoms is a stroke affecting the spinal cord. This happens when blood flow to the spinal cord is blocked. This blockage can occur during or after certain surgeries, particularly on the aorta. Blood clots can also contribute to this type of stroke. Early diagnosis and treatment are crucial for a good outcome.

Transverse myelitis is a condition causing inflammation in the spinal cord. The exact cause isn't always clear. Sometimes, no specific cause is found.

Infections can trigger transverse myelitis. These infections might involve viruses, bacteria, or fungi that affect the spinal cord. Often, the inflammatory condition appears after the person has recovered from the initial infection.

Several viruses are linked to transverse myelitis, including:

• Herpes viruses: These include the virus that causes shingles and chickenpox (varicella-zoster virus).
• Other viruses: Cytomegalovirus, Epstein-Barr virus, HIV, enteroviruses (like poliovirus and coxsackievirus), West Nile virus, Echovirus, Zika virus, influenza, hepatitis B, and mumps, measles, and rubella viruses.

Some viruses might not directly infect the spinal cord, but they can still cause an immune response that leads to transverse myelitis.

Bacterial infections sometimes connected to transverse myelitis include:

• Lyme disease
• Syphilis
• Tuberculosis
• Actinomyces
• Pertussis (whooping cough)
• Tetanus
• Diphtheria

Even bacterial skin infections, stomach bugs (gastroenteritis), and certain types of pneumonia can sometimes trigger the condition.

Rarely, parasites or fungal infections can affect the spinal cord and potentially cause transverse myelitis.

Certain medical conditions can also lead to transverse myelitis:

• Multiple sclerosis (MS): In MS, the body's immune system mistakenly attacks the protective covering (myelin) around nerves in the brain and spinal cord. Transverse myelitis can be an initial sign of MS, or it might be a relapse (a return of symptoms). MS-related transverse myelitis usually affects only one side of the body.
• Neuromyelitis optica (NMO, or Devic's disease): NMO causes inflammation and damage to the myelin around the spinal cord and the optic nerve (the nerve in the eye that carries signals to the brain). NMO-related transverse myelitis often affects both sides of the body. People with NMO might also experience optic nerve problems, like eye pain with movement and temporary vision loss. These eye problems can occur with or without the spinal cord inflammation. Some people with NMO only have recurrent episodes of transverse myelitis and don't have eye problems.
• Autoimmune disorders: Conditions like lupus (which can affect many parts of the body) and Sjogren's syndrome (which causes dry eyes and mouth) can sometimes contribute to transverse myelitis. Transverse myelitis linked to an autoimmune disorder could be a sign of NMO, as people with autoimmune diseases are more likely to develop NMO.
• Vaccinations: While vaccines are sometimes mentioned in connection with transverse myelitis, the link isn't strong enough to recommend avoiding any vaccines.
• Sarcoidosis: This is a condition causing inflammation in various parts of the body, including the spinal cord and optic nerve. It can mimic NMO, but sarcoidosis symptoms typically develop more gradually. The cause of sarcoidosis is not fully understood.

It's important to note that many factors can cause transverse myelitis, and a doctor can determine the cause of a person's symptoms.

Transverse myelitis is often a one-time event. But, after the initial episode, people may experience lasting problems. These are some common issues:

• Pain: This is a very frequent and often frustrating long-term effect. The pain can range from mild discomfort to severe, constant agony, making daily life challenging.

• Muscle Stiffness, Tightness, or Spasms (Spasticity): Many people experience muscle tightness, stiffness, or painful spasms, especially in their buttocks and legs. These spasms can be unpredictable and uncomfortable, interfering with movement and daily activities.

• Partial or Complete Loss of Movement (Paralysis): Some people may experience weakness or paralysis in their arms, legs, or both, even after the initial symptoms have subsided. This can significantly impact their ability to perform everyday tasks.

• Sexual Problems: Transverse myelitis can affect sexual function in both men and women. Men may have trouble getting an erection or reaching climax. Women may also experience difficulties reaching orgasm. These issues can be emotionally distressing and can impact relationships.

• Depression and Anxiety: Living with long-term complications from transverse myelitis can be very stressful. The physical pain, loss of mobility, and sexual dysfunction can lead to feelings of sadness, hopelessness, or anxiety. These emotional difficulties are very common and require support.

Diagnosing Transverse Myelitis

Doctors diagnose transverse myelitis by asking about your symptoms and medical history, doing a physical exam to check your nerve function, and running some tests. These tests help find out if you have spinal cord inflammation and rule out other possible problems.

Tests to Diagnose Transverse Myelitis

• Lumbar Puncture (Spinal Tap): A small amount of cerebrospinal fluid (CSF), the fluid surrounding your brain and spinal cord, is collected using a needle. This fluid is checked for signs of inflammation. High levels of white blood cells or proteins related to the immune system in the CSF suggest inflammation. Tests can also look for viruses or cancer cells.

• Blood Tests: These tests can be important for several reasons. One type of blood test looks for antibodies linked to neuromyelitis optica (NMO). NMO is a condition causing inflammation in the spinal cord and the optic nerve (the nerve in your eye). If you have these antibodies, you're more likely to have repeated attacks of transverse myelitis, so treatment will focus on preventing future attacks. Other blood tests check for infections that might be causing the transverse myelitis or rule out other possible causes of your symptoms.

• Magnetic Resonance Imaging (MRI): An MRI uses magnets and radio waves to create detailed pictures of soft tissues, like your spinal cord. An MRI can show any signs of inflammation in your spinal cord, and it can also help find other things that might be causing your symptoms, such as problems with your spinal cord or blood vessels.

These tests work together to help doctors figure out the cause of your symptoms and develop the best treatment plan. A doctor will explain the results of the tests and discuss treatment options with you.