Transverse myelitis is an inflammation of the spinal cord which damages or destroys myelin, the material which sheathes nerves. The damage to the myelin causes neurological symptoms such as weakness in the legs or abnormal sensations such as tingling, heat, and cold on the body. The prognosis for someone diagnosed with transverse myelitis varies, depending on the location of the inflammation and the severity; some patients make a full recovery with treatment, while others may be permanently disabled.
The cause of transverse myelitis can be quite varied. It can be a complication of an infection or an immune disorder, the result of abnormal bloodflow to the spine, or idiopathic in nature, meaning that there is no known cause. Understanding the cause is an important part of diagnosis and treatment, because it can impact the treatment options for the patient, as well as the prognosis.
The “transverse” in “transverse myelitis” is a reference to the fact that the inflammation spans across an area of the spinal cord. Common symptoms of the condition include weakness in the legs, lack of bladder or bowel control, abnormal physical sensations, and pain. Pain or abnormal sensations in specific areas of the body correspond to the nerves involved in the inflammation.
To diagnose transverse myelitis, a neurologist conducts an examination and patient interview to learn more about the symptoms and when they appeared. The doctor may use a medical imaging study to look at the spine, and he or she may also recommend myelography, in which a tracer dye is injected and followed with imaging equipment. Blood draws may be taken to check for signs of infection which could provide a clue to the cause.
Immediate treatment for transverse myelitis usually involves the use of anti-inflammatory drugs to reduce the inflammation. This will help reduce the risk of further damage, and make the patient more comfortable. Drugs may also be given to address the cause, as in the case when a patient develops transverse myelitis as a complication of a bacterial infection. Once the patient is stabilized, transverse myelitis recovery can begin.
Recovery often includes physical therapy to help the patient get active and determine the extent of the damage. If the damage is minimal and the patient works hard in physical recovery, he or she can make a full recovery within several months, with around a third of transverse myelitis patients recovering successfully. More serious damage, even with excellent physical therapy, can result in long-term disability or serious incapacitation.
