Transverse Myelitis

Transverse myelitis (TM) is a rare inflammatory condition that affects the spinal cord, causing damage to the myelin sheath, which is the protective covering of nerve fibers. This damage disrupts the normal flow of electrical impulses along the spinal cord, leading to a range of symptoms.

What is Transverse Myelitis?

Transverse myelitis is characterized by inflammation across a segment of the spinal cord, typically affecting both sides of the cord (hence "transverse"). The condition can occur at any level of the spinal cord, from the neck to the lower back. TM can be caused by various factors, including viral infections, autoimmune disorders, and other medical conditions.

Symptoms of Transverse Myelitis

The symptoms of transverse myelitis can vary depending on the level and severity of the inflammation. Common symptoms include:

• Pain: Back pain, muscle spasms, or stiffness in the neck, back, or arms and legs
• Weakness or numbness: Muscle weakness, numbness, tingling, or burning sensations in the arms, legs, or trunk
• Sensory changes: Changes in sensation, such as decreased sensitivity to touch, temperature, or vibration
• Bladder and bowel dysfunction: Difficulty urinating, constipation, or loss of bladder or bowel control
• Paralysis: Partial or complete paralysis of the arms, legs, or trunk
• Sphincter disturbances: Loss of control over the bowels or bladder
• Sexual dysfunction: Impotence, erectile dysfunction, or decreased libido

Causes and Risk Factors

Transverse myelitis can be caused by various factors, including:

• Viral infections: Such as herpes simplex, varicella-zoster, or enterovirus
• Autoimmune disorders: Such as multiple sclerosis, lupus, or rheumatoid arthritis
• Bacterial infections: Such as Lyme disease or tuberculosis
• Parasitic infections: Such as toxoplasmosis or schistosomiasis
• Trauma: Spinal cord injury or trauma
• Neoplastic conditions: Tumors or cancer affecting the spinal cord

Treatments for Transverse Myelitis

The treatment of transverse myelitis depends on the underlying cause and severity of the condition. Common treatments include:

• Corticosteroids: To reduce inflammation and swelling in the spinal cord
• Plasmapheresis: To remove antibodies from the blood that may be contributing to the inflammation
• Intravenous immunoglobulin (IVIG): To modulate the immune system and reduce inflammation
• Antiviral or antibacterial medications: To treat underlying infections
• Pain management: Medications to manage pain, such as opioids or non-steroidal anti-inflammatory drugs (NSAIDs)
• Physical therapy: To maintain muscle strength and mobility
• Occupational therapy: To adapt to any permanent disabilities or limitations

Prognosis and Outcome

The prognosis for transverse myelitis varies depending on the severity of the condition, the level of the spinal cord affected, and the underlying cause. Some people may experience complete recovery, while others may have persistent symptoms or disability. In general, the outcome is better if treatment is started early and the underlying cause is addressed promptly.