Transverse Myelitis - Symptoms, Prognosis, Treatment, Causes
What is Transverse Myelitis?
It is an inflammation of your spinal cord. Having this medical condition can result in a variety of muscle and neurological symptoms. When you break the medical condition into two words, transverse means the inflammations position and myelitis means inflammation of your spinal cord. Transverse myelitis can occur in both children and adults. It can affect all races and genders. Each year the number of new cases happens between the ages of ten and nineteen and between the ages of thirty and thirty-nine. In the United States, each year there are approximately one thousand four hundred new cases. Approximately thirty-three thousand people in the United States have some kind of disability from having this medical condition.
The symptoms can vary from person to person. Approximately a third of the people with transverse myelitis stated that they began suffering flu-like symptoms such as running a fever before they began to develop the symptoms of this medical condition. Although it does not always happen, both sides of the body are commonly affected. Some of the general symptoms can include:
- A loss of spinal cord function. This can happen over a few hours or it can happen over several weeks.
- It can begin suddenly as lower back pain, abnormal sensations in your feet and toes, weakness in your muscles, and progress to symptoms that are more severe quickly.
- Having a tightening sensation around your trunk
- Muscle spasms
- General feeling of discomfort
- Loss of appetite
- Numbness or tingling in your legs
- Weakness in your arms or legs
- Reduced reflexes
- Pain that will usually begin in your back or neck quite suddenly. It depends on which part of the spinal cord is affected.
- You can have sensations that are shooting or sharp that can radiate down your arms or legs or around your middle.
- You may have abnormal sensations burning or coldness. You may feel as if the skin of your legs, chest, or abdomen is wrapped by something tight. Some may be sensitive to extreme cold or heat or to light.
- Urinary retention, incontinence, increased urges to urinate.
- Losing control of your bowels.
- Paralysis, especially in your legs.
If you have an injury or disease it is a normal for your immune system to respond with inflammation. Sometimes your immune system will attack their own body’s tissues. Why this dysfunction in your immune system that causes transverse myelitis the exact reason is not known. There are many conditions that seen to either contribute or trigger transverse myelitis.
These can include:
- Having a viral infection of the gastrointestinal or respiratory tract. Most of the time transverse myelitis will happen after you have recovered from either viral infection.
- Having a mild form of pneumonia called mycoplasma pneumonia, which is caused by a bacterium. This could be a trigger that could cause this medical condition.
- Having another autoimmune disorder called multiple sclerosis. In this autoimmune disorder the immune system destroys the myelin that is surrounding the nerves in your brain and spinal cord. It is thought that transverse myelitis could be the first sign of a person having multiple sclerosis or it could represent a relapse of the symptoms of multiple sclerosis. If transverse myelitis occurs as a sign of multiple sclerosis it will usually hit just only one side of the body.
- Having neuromyelitis optica (Devic’s disease). This is a medical condition that causes the loss of myelin around your optic nerve and the spinal cord along with inflammation. When you have this medical condition the symptoms of transverse myelitis will normally affect both sides of the body.
- Having an autoimmune disorder that is affecting other systems of your body could be a contributing factor in some people. One of these autoimmune disorders is lupus which can affect many systems of your body.
- Having vaccinations for an infectious disease such as measles-mumps-rubella, diphtheria-tetanus or hepatitis B
- Having a bacterial infection
Most of the time the cause is idiopathic, which means that what causes transverse myelitis is not known.
There are several therapies that can be used to treat the acute symptoms, which can include:
- Being given steroids intravenously. When you are diagnosed with transverse myelitis it is likely that you will receive steroids over several days to help reduce the inflammation of your spinal column. The injections are given in your veins.
- Having plasma exchange therapy which may be done if a person does not respond to intravenous steroids. When you have this therapy they will remove from the blood cells the straw-colored fluid (plasma) and replace it with special fluids.
- Pain medication because one common complaint in having transverse myelitis is having chronic pain. Taking the medication may help to decrease the pain that is associated with the damage to your spinal cord. Most of the pain medication can be bought over-the-counter and can include ibuprofen, naproxen, and acetaminophen.
- Being given medications to treat any other complications such as bowel or urinary dysfunction, depression, or muscle spasticity.
These types of therapy focus on care and long-term recovery.
- Physical therapy to help you improve your coordination and increase your strength.
- Occupational therapy to help you learn new ways to perform your day-to-day activities such as cleaning your house, taking a bath, fixing meals.
- Psychotherapy to help treat depression, other behavioral or emotional issues, anxiety, etc.
Most people who have transverse myelitis have at least a partial recovery although it may take a year or longer. How long it takes to recover and how much a person recovers depends on what caused transverse myelitis. Approximately a third of the people who have transverse myelitis fall into one of these three categories after having an episode of this medical condition.
- Slight or no disability - they only experience symptoms with minimal residue
- Moderate disability - they are mobile but could have tingling or numbness, bowel and bladder problems, and difficulty in walking.
- Severe disability - they may need continual assistance with everyday activities and care, and need a wheelchair permanently.
Generally if the symptoms come on quickly those people will have a worse prognosis than the ones with symptoms that appeared slower.