Transverse Myelitis: What It Is, Symptoms, Causes And Treatment
Transverse myelitis is a disease of the spinal cord that causes symptoms such as muscle pain and weakness; In the most serious cases these alterations can remain throughout life.
In this article we will describe What is transverse myelitis, what are its symptoms and main causes and how it can be treated.
Myelitis are diseases that consist of inflammation of the spinal cord whether this is the cause of the patient’s symptoms or a consequence of another disorder of the central nervous system.
The name “myelitis” comes from the fact that they are frequently affected nerve fibers covered with myelin sheaths a substance that insulates axons and facilitates the transmission of electrochemical impulses between neurons.
“Transverse myelitis” is the term used to describe this disease when inflammation occurs on both sides of a section of the spinal cord. We speak of partial transverse myelitis when the inflammation extends to both sides of the spinal cord but incompletely.
In general, the damage is limited to a small area of the spinal cord, although the severity of myelitis varies depending on the case. The interruption in the sending of signals along the spine causes physical alterations and deficits of various kinds.
Main symptoms and signs
Symptoms of transverse myelitis usually affect both sides of the body below the damaged section of the spinal cord. Although in general the development of these symptoms occurs in a matter of hours or days, sometimes it is slower, and may take weeks to fully evolve.
In many cases, transverse myelitis is detected by the sudden appearance of severe, stabbing pains in the lower back and legs Depending on the part of the spinal cord affected, pain may occur in other parts of the body, such as the chest and abdomen.
2. Muscle weakness
Muscle weakness usually affects the legs, causing feelings of heaviness in the lower extremities and difficulty walking. If the damaged section is located in a high part of the spinal cord, weakness may also occur in the arms.
3. Paralysis
In the context of transverse myelitis, muscle paralysis occurs as a progression of limb weakness, particularly in the legs. When the paralysis is partial we speak of paraparesis, while if it is complete the correct term is paraplegia.
4. Sensory alterations
Abnormal sensations that may occur as a result of myelitis include tingling, numbness, itching, burning, and sensitivity to intense heat and cold. Common body parts affected are the legs, torso, and genitals. It is also common for sensory deficits to occur.
5. Sphincter dysfunction
Alteration in the function of the bladder and intestines It manifests itself in the presence of urinary incontinence, difficulties urinating and defecating, and constipation.
Causes of this disease
Most cases of transverse myelitis occur as a result of disorders that affect the nervous system. However, sometimes there is no identifiable cause; In these cases we speak of “idiopathic transverse myelitis”.
1. Immune system disorders
There are many immune disorders that are related to inflammation of the spinal cord. Between these post-infectious and post-vaccine reactions stand out and multiple sclerosis, to which we dedicate a separate section.
Transverse myelitis can also occur as a consequence of autoimmune disorders such as systemic lupus erythematosus, neuromyelitis optica, and Sjogren’s syndrome.
2. Multiple sclerosis
Multiple sclerosis is a particularly common immune disorder that causes the destruction of the myelin sheaths that wrap around the axons of the central nervous system. When this disease is present, it is common for transverse myelitis to appear as one of its first signs.
3. Viral and other infections
Viral infections are a common cause of transverse myelitis, which usually occurs during the recovery period. Herpetic viruses such as chickenpox and cytomegalovirus are some of the most common in this sense.
In addition, infections by bacteria (such as syphilis and tuberculosis), fungi (such as cryptococci) and parasites (such as toxoplasmosis) can also cause inflammation of the bone marrow. However, this problem is more common in viral infections.
4. Other inflammatory diseases
Systemic lupus erythematosus, mixed connective tissue disease, sarcoidosis, scleroderma, Sjogren’s syndrome, among other diseases, can also cause inflammation in the nerve fibers of the spinal cord. In many cases these disorders are related to the immune system
Transverse myelitis treatment
Although transverse myelitis can cause chronic problems, if treatment is started early the symptoms and signs usually reduce in a matter of weeks, although they can take almost two years to completely subside. The prognosis is worse if there is no improvement after about five months of treatment.
Treatment of transverse myelitis usually consists of the administration of medications combined with physical rehabilitation therapy, which aims to improve muscle strength and coordination. Sometimes it is necessary to use assistive devices, such as crutches or wheelchairs, temporarily or permanently.
Some of the most used drugs in the treatment of myelitis are intravenous corticosteroids such as methylprednisolone and dexamethasone, which can reduce inflammation of the marrow. The specific medications used will depend on the cause; Thus, if the disease is due to a virus, antivirals will be administered.
When the body does not respond adequately to corticosteroids, plasma exchange therapy (plasmapheresis) can be applied, which consists of extracting blood plasma and replacing it with special fluids. In this way, the aim is to eliminate the antibodies responsible for spinal inflammation.
In addition, drugs are frequently administered to treat secondary symptoms; For example, Pain relievers and muscle relaxants are used to reduce pain and if sexual or emotional dysfunctions are present, specific medications can be prescribed for these alterations.
