Transverse Myelitis

Transverse myelitis is a condition caused by inflammation of the spinal cord. As a result, the covering (myelin sheath) around the nerve cells is damaged. This disturbs the signals between spinal nerves and rest of the body. Symptoms may develop suddenly or over days or weeks. Classic symptoms include:

Weakness of the arms and legs that can lead to difficulty walking (stumbling or dragging your feet).

• Partial loss of function, which may develop into paralysis.
• Sensory alterations such as burning, pricking, numbness, or sensory loss.
• Pain (usually in the lower back or down the legs and arms or around the torso).
• Bowel and bladder dysfunction.

Transverse myelitis is a rare nervous system disorder. In many cases, the cause is unknown. However, certain conditions may lead to transverse myelitis:

• Bacterial, viral, parasitic, or fungal infection, such as HIV, syphilis, varicella zoster (shingles), West Nile virus, Zika virus, enteroviruses, and Lyme disease
• Immune system disorders, such as multiple sclerosis (MS), Sjögren syndrome, and lupus
• Other inflammatory disorders, such as sarcoidosis, or a connective tissue disease called scleroderma
• Blood vessel disorders that affect the spine

Transverse myelitis can affect people of any age, but a peak in incidence rates appears to occur between 10 and 19 years of age and 30 to 39 years of age.

Prognosis

Most people with transverse myelitis have at least partial recovery, with most recovery taking place within the first 3 months after the attack. Recovery may continue for up to 2 years (and sometimes longer) in some people. Some individuals may have moderate disability while others have permanent weakness and other complications. Many individuals experience only one episode of transverse myelitis.

Treatment

No effective cure currently exists for people with transverse myelitis. Physicians often prescribe corticosteroid drugs to decrease inflammation and reduce immune system activity. Plasma exchange therapy may be used for people who don't respond well to intravenous steroid drugs. Medications may be prescribed to treat pain and other symptoms and complications. Many children require a comprehensive, interdisciplinary inpatient rehabilitation program to maximize recovery and function after the acute illness is treated. Pediatric physiatrists prescribe programs, therapies, medications, and equipment to help maximize recovery and function in an inpatient rehabilitation program, and throughout early adulthood.

NIH: National Institute of Neurological Disorders and Stroke