Transverse myelitis (TM) is the inflammation across a segment of the spinal cord, damaging and/or destroying the myelin surrounding the nerve cell fibers. It is referred to as a neurological disorder since it affects and spinal cord and the nervous system's ability to communicate with the rest of the body. Each year in the US, approximately 1,400 new cases of transverse myelitis are reported. It is estimated that 33,000 Americans have some disorder associated with the disease. Recovery from the disorder usually occurs within 2 to 12 weeks from the onset of symptoms and can continue up to 2 years. If there is no improvement within 3 to 6 months, recovery is unlikely.
What causes it?
The exact cause of the disease is unknown, and it can occur in any age, gender, or race. It may result from abnormal immune reactions, insufficient blood flow through the vessels, or viral infections (HIV, hepatitis A, influena, etc). Transverse myelitis also may occur as a consequence of syphilis, measles, or Lyme disease. Some vaccinations, such as those for chickenpox and rabies, have been associated with the disorder. Some researchers even believe that it is an autoimmune disease because it has been shown in persons with other autoimmune disorders. Spinal AVMs and vascular diseases have also been indicative of causing transverse myelitis. Hemorrhage within the spinal cord and blockage of a blood vessel causes ischemia to the spinal cord. When the spinal cord does not get the proper oxygen and nutrients it needs, inflammation can occur, resulting in TM.
What are the symptoms?
Pain is the most common presenting symptom of transverse myelitis. The pain can be localized to the lower back or it can radiate down the legs or arms or around the torso. The other symptoms can include muscle spasms, sensory loss, and partial paralysis of the legs that can progress to paraplegia. Sudden sensations such as burning, tickling, pricking, or tingling in the legs and sometimes arms are also noted. Bladder and bowel dysfunction is commonly seen in some cases. Respiratory problems may occur depending on the segment of the spinal cord.
How is it diagnosed?
Neurological exams are performed to first indicate if the problems are neurological. Blood tests them may be given to rule out other disease. A myelogram may be requested, but most commonly a MRI will be performed to check for inflammation and location.
How is it treated?
There is no cure for transverse myelitis. Treatment focuses on alleviating pain and symptoms that result from the stages and severity of the disorder. Corticosteriod therapy is usually first used to decrease inflammation. Analgesics are oftem prescribed to reduce pain. Physical therapy is used when the stages of paralysis infest. Some patients are commonly treated in rehabilitation homes when the paralysis becomes paraplegia.
References:
http://www.ninds.nih.gov/disorders/transversemyelitis/detail_transversemyelitis.htm
http://www.uiowa.edu/~c064s01/nr187.htm
http://www.nature.com/sc/journal/v44/n11/fig_tab/3101879f1.html
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