Transverse Myelitis: Symptoms, Causes, and Treatments

Transverse myelitis is an inflammation of the spinal cord that has different origins. Learn more about this condition and how it's treated in this article!
Transverse Myelitis: Symptoms, Causes, and Treatments

Last update: 28 May, 2021

Transverse myelitis is the inflammation of a segment of the spinal cord. It can have various causes and different symptoms.

Here, we’ll tell you everything you need to know about this disorder.

What is transverse myelitis?

Transverse myelitis is the inflammation of a transverse segment of the spinal cord. The inflammatory process causes the destruction of the myelin sheath, which is the layer that covers the neurons found in this area. This interrupts nerve conduction, with the consequences we will discuss later.

It’s a relatively common disorder that affects thousands of people worldwide. Within this affected group, many of them are left with permanent alterations that affect their daily life, while others recover without sequelae. Transverse myelitis can be acute, developing over hours or days, or chronic if it develops over weeks.

What are the causes of transverse myelitis?

The exact cause of this disorder isn’t entirely clear. However, it’s believed to be due to an abnormal response of our immune system, which attacks the spinal cord tissue.

This immune response is related to other pathologies that could act as triggers. Some of the diseases that could trigger a disproportionate immune response are:

  • Multiple sclerosis: This is the disease most closely related to transverse myelitis.
  • Neuromyelitis optica.
  • Diseases produced by some viruses and bacteria, such as tuberculosis, Lyme disease. or syphilis.
  • Different types of vasculitis – inflammation of the blood vessels.
  • The use of certain drugs and vaccines.
A person with lower back pain.
The spinal cord’s the are of the body area that transverse myelitis effects.

Continue reading: What It’s Like to Live With Multiple System Atrophy

Symptoms it produces

As mentioned above, symptoms may appear acutely, or occur over several days in a progressive manner. Normally, the picture begins with severe back pain and a feeling of tightness along the affected band.

Following this pain, the person begins to notice tingling in the legs and feet and a feeling of numbness. There may also be increased sensitivity to touch and heat in some areas. There may be an urgent need to go to the bathroom.

As the condition progresses, these symptoms worsen. Paralysis, loss of feeling, urinary retention, and loss of bladder and bowel control may result. Both the severity and duration of the symptoms and the degree of disability it produces, will depend on the degree of inflammation in the affected area.

Diagnosis of transverse myelitis

The diagnosis will be based on physical examination by a specialist. Although the symptoms may suggest this disease, the doctor will need to differentiate it from some others that cause a similar picture. That’s why, in addition to a correct examination, other tests will be requested.

These complementary tests can be imaging -such as magnetic resonance imaging-, or analytical -such as a lumbar puncture. Once the result has been confirmed, treatment will be established as quickly as possible in order to minimize the sequelae.

What is the treatment?

A person getting a lumbar puncture.
Doctors may perform a lumbar puncture as a complementary method for the diagnosis of the origin of transverse myelitis.

Treatment will depend on the relationship between the myelitis and an underlying disease. Just the same, the priority is to treat the underlying disease. For example, if the myelitis is caused by tuberculosis, the treatment that the specialist will administer will be that of tuberculosis.

In addition to this, or if no clear cause of the myelitis has been found, it may be treated with corticosteroids. Another option may be plasmapheresis, which consists of extracting a significant amount of blood from the affected person, removing the antibodies that are attacking the myelin, and re-injecting it without them.

As always, it’s the doctor in charge of the case who’ll decide which will be the most appropriate treatment in each case.

A long illness that can have long-term ramifications

The prognosis of the disease will depend on many factors. The recovery of muscle activity and sensitivity usually begins between 2 and 12 weeks from the onset of symptoms.

Recovery can be slow and may take years. At the same time, if there’s no improvement in the first 6 months, the patient may never fully recover normal function.

One-third of those affected will recover completely, another third will have more or less severe sequelae, and another third will not recover at all. As always, it’s important to remember that, when any symptom appears, you need to go to a specialist who’ll be the best person to evaluate the situation and establish the steps you need to take.

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