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Transverse Myelitis

Transverse myelitis is a neurological condition that happens when both sides of the same section of the spinal cord become inflamed. This inflammation can damage myelin, the fatty substance that covers your nerves. Loss of myelin often leads to spinal cord scarring that blocks nerve impulses and results in physical problems.

Transverse myelitis is a relatively rare disease. It occurs most often in children ages 10 to 19 and in adults ages 30 to 39, but it can happen at any age.

Causes

Experts don’t know the exact cause of transverse myelitis. The inflammation that leads to transverse myelitis can result as a side effect of a number of other conditions, including:

  • Lyme disease

  • Syphilis

  • Measles

  • Viral infections

  • Bacterial infections

Some people may also get transverse myelitis as a result of spinal injuries, spinal malformations, or vascular diseases like atherosclerosis, all of which can reduce the amount of oxygen in spinal cord tissue. If parts of the spinal cord don’t have enough oxygen, nerve cells often begin to die. The dying tissue can cause the inflammation that leads to transverse myelitis.

Transverse myelitis can also be a warning sign of multiple sclerosis, but this is a rare occurrence. Since some people with transverse myelitis have autoimmune diseases such as lupus, some doctors believe that transerve myelitis may also be an autoimmune disease. Finally, some cancers can trigger an immune response that leads to transverse myelitis.

Symptoms

The physical symptoms of transverse myelitis can develop over several hours or days, or over a longer period of one to two weeks. These are possible symptoms:

  • Back or neck pain

  • Weakness in arms or legs

  • Abnormal feelings in the legs, such as burning, tingling, or pricking

  • Loss of bladder or bowel control

  • Heightened sensitivity to touch

The location on the body of these symptoms depends on what part of the spinal cord is inflamed. People with inflammation in the neck typically feel symptoms from the neck down, while inflammation in the middle of the spine can cause symptoms from the waist down.

Diagnosis

If you suspect that you have transverse myelitis, your doctor will likely review your medical history and perform a complete physical examination. Because transverse myelitis can be caused by a number of treatable conditions, your doctor may want to test for some of those diseases. One diagnostic test you might need is a CT or MRI scan.

Another common test is myelography, a procedure in which a needle is used to inject a special dye into your spinal area. A technician will then use a real time X-ray called fluoroscopy to get pictures of your spinal cord.

If all potential underlying causes of transverse myelitis have been ruled out, your condition may be considered idiopathic, which means that there is no known cause for it.

Treatment

No effective cure currently exists for transverse myelitis. Treatments focus on relieving the inflammation that causes the symptoms. High doses of steroids, which suppress the activity of the immune system, are the most common treatments. Your doctor may also recommend pain-relieving drugs like ibuprofen or acetaminophen and plenty of bed rest.

If steroids don’t relieve the symptoms of transverse myelitis, your doctor may try a procedure called plasma exchange, which exchanges the plasma in your blood for new plasma. This procedure removes harmful antibodies from the blood. Other immune-suppressing drugs may also be prescribed.

Recovery

Recovery from transverse myelitis usually begins from two to 12 weeks after you first experience symptoms. Recovery can take up to two years. About one-third of people with transverse myelitis have full or near-full recovery, with most of their symptoms gone. Another third have fair recovery, retaining some of their symptoms. The last third recover poorly and experience significant physical disabilities. Most people will only have one episode of transverse myelitis, however a small percentage of people may have a recurrence.  

Therapies for permanent disabilities

Some people who get transverse myelitis are left with permanent physical disabilities, such as muscle stiffness, loss of bowel or bladder function, muscle weakness, and even paralysis. If you have any of these impairments, physical therapy may be prescribed. In this treatment, specialists will work with you to increase your strength, improve your coordination, and help you gain more control over bladder and bowel functions.

Another type of therapy is occupational therapy, which helps you learn new ways of doing everyday tasks, like bathing, in spite of your new physical limitations. Finally, some people with physical disabilities often feel sad or depressed. If this happens to you, your doctor may recommend that you see a mental health professional. Antidepressant medications and psychotherapy, or “talk therapy,” are both available to help treat depression.

Online Medical Reviewer: Sohrabi, Farrokh, MD
Online Medical Reviewer: Ziegler, Olivia Walton, MS, PA-C
Date Last Reviewed: 6/24/2012
© 2000-2014 Krames StayWell, 780 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.