Transverse Myelitis – Transverse Myelitis (TM) is an autoimmune disease where the immune system mistakenly attacks the spinal cord due to a virus or other infection. The spinal cord carries nerve signals to and from the brain through nerves that extend from each side of the spinal cord and connect to nerves elsewhere in the body.
About Transverse Myelitis
Causes of transverse myelitis include infections, immune system disorders, and other disorders that may damage or destroy myelin, the fatty white insulating substance that covers nerve cell fibers. Inflammation within the spinal cord interrupts communications between nerve fibers in the spinal cord and the rest of the body, affecting sensation and nerve signaling below the injury. Symptoms include pain, sensory problems, weakness in the legs and possibly the arms, and bladder and bowel problems. The symptoms may develop suddenly (over a period of hours) or over days or weeks.
Transverse myelitis can affect people of any age, gender, or race. It does not appear to be genetic or run in families. A peak in incidence rates (the number of new cases per year) appears to occur between 10 and 19 years and 30 and 39 years. It is estimated that about 1,400 new cases of transverse myelitis are diagnosed each year in the United States.
Transverse Myelitis Symptoms
- weakness of the legs and arms
- pain
- bowel and bladder dysfunction
Transverse Myelitis Diagnosis
SPECIALISTS
- Neurosurgeon
BLOOD TESTS
- Antibody Test
- Vitamin b12
- HIV Test
MEDICATIONS
- Corticosteroid
- Plasmapheresis
- Antiviral medications
Transverse Myelitis Treatment
Although some people recover from transverse myelitis with minor or no residual problems, the healing process may take months to years. Others may suffer permanent impairments that affect their ability to perform ordinary tasks of daily living. Some individuals will have only one episode of transverse myelitis; other individuals may have a recurrence, especially if an underlying illness caused the disorder.
Treatments are designed to address infections that may cause the disorder, reduce spinal cord inflammation, and manage and alleviate symptoms.
Initial treatments and management of the complications of transverse myelitis
- Intravenous corticosteroid drugs may decrease swelling and inflammation in the spine and reduce immune system activity. Such drugs may include methylprednisolone or dexamethasone (usually administered for 3 to 7 days and sometimes followed by a tapering off period). These medications may also be given to reduce subsequent attacks of transverse myelitis in individuals with underlying disorders.
- Plasma exchange therapy (plasmapheresis) may be used for people who don’t respond well to intravenous steroids. Plasmapheresis is a procedure that reduces immune system activity by removing plasma (the fluid in which blood cells and antibodies are suspended) and replacing it with special fluids, thus removing the antibodies and other proteins thought to be causing the inflammatory reaction.
- Intravenous immunoglobulin (IVIG) is a treatment thought to reset the immune system. IVIG is a highly concentrated injection of antibodies pooled from many healthy donors that bind to the antibodies that may cause the disorder and remove them from circulation.
- Pain medicines that can lessen muscle pain include acetaminophen, ibuprofen, and naproxen. Nerve pain may be treated with certain antidepressant drugs (such as duloxetine), muscle relaxants (such as baclofen, tizanidine, or cyclobenzaprine), and anticonvulsant drugs (such as gabapentin or pregabalin).
- Antiviral medications may help those individuals who have a viral infection of the spinal cord.
- Medications can treat other symptoms and complications, including incontinence, painful muscle contractions called tonic spasms, stiffness, sexual dysfunction, and depression.
There is no cure for transverse myelitis.
