Transverse myelitis is a disease of the spinal cord that causes symptoms such as muscle pain and weakness; in the most severe cases, these alterations can be maintained throughout life.
In this article we will describe what is transverse myelitis, what are its main symptoms and causes and how it can be treated.
What is transverse myelitis?
Myelitis is a disease that involves inflammation of the spinal cordWhether it is the cause of the patient’s symptoms or the consequence of another central nervous system disorder.
The name “myelitis” comes from the fact that they are often affected nerve fibers covered with myelin sheaths, A substance that isolates axons and facilitates the transmission of electrochemical impulses between neurons.
“Transverse myelitis” is the term used to refer to this disease when inflammation occurs on both sides of a section of the spinal cord. Partial transverse myelitis is when the inflammation spreads to both sides of the spinal cord but not completely.
Damage is usually limited to a small area of the spinal cordAlthough the severity of myelitis varies from case to case. Interruption of the sending of signals along the spine leads to physical alterations and deficits of various kinds.
Main symptoms and signs
Symptoms of transverse myelitis usually affect both sides of the body under the damaged section of the spinal cord. While the development of these symptoms usually occurs within hours or days, sometimes it is slower and may take weeks to fully evolve.
In many cases, transverse myelitis is detected by the sudden onset of severe, shooting pains in the lower back and legs. Depending on the part of the bone marrow affected, it can cause pain in other parts of the body, such as the chest and abdomen.
2. Muscle weakness
Muscle weakness usually affects the legs, causing a feeling of heaviness in the lower limbs and difficulty walking. If the damaged section is located in a raised part of the spinal cord, weakness can also occur in the arms.
Against the background of transverse myelitis, muscle paralysis occurs as a progression of limb weakness, Particularly in the legs. When the paralysis is partial, it is called paraparesis, whereas if it is complete, the correct term is paraplegia.
4. Sensory alterations
Abnormal sensations that can appear as a result of myelitis include tingling, numbness, itching, burning, and sensitivity to intense heat and cold. The most commonly affected parts of the body are the legs, torso and genitals. It is also common for sensory deficits to occur.
5. Sphincter dysfunction
Impaired bladder and bowel function it manifests itself in the presence of urinary incontinence, difficulty urinating and defecating, and constipation.
The causes of this disease
Most cases of transverse myelitis occur as a result of disorders affecting 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 associated with inflammation of the spinal cord. Among these post-infectious and post-vaccine reactions stand out and multiple sclerosis, to which we devote a separate section.
Transverse myelitis can also occur as a result of autoimmune diseases such as systemic lupus erythematosus, neuromyelitis optic, and Sjögren’s syndrome.
2. Multiple sclerosis
Multiple sclerosis is a particularly common immune disorder that causes the destruction of the myelin sheaths that surround 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. Herpes viruses like chickenpox and cytomegalovirus are among the most common in this regard.
In addition, bacterial infections (such as syphilis and tuberculosis), fungi (such as cryptococci) and parasites (such as toxoplasmosis) can also cause inflammation of the spinal cord. However, this problem is more common in viral infections.
4. Other inflammatory diseases
Systemic lupus erythematosus, mixed connective tissue disease, sarcoidosis, scleroderma, Sjögren syndrome, among other diseases, can also cause inflammation of the nerve fibers in the spinal cord. In many cases, these disorders are related to the immune system.
Treatment of transverse myelitis
Although transverse myelitis can cause chronic problems, if treatment is started early, symptoms and signs usually go away within a few weeks, although it can take almost two years to go away completely. The prognosis is worse if no improvement occurs after about five months of treatment.
Treatment of transverse myelitis usually consists of the administration of drugs associated 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 drugs most used in the treatment of myelitis are intravenous corticosteroids such as methylprednisolone and dexamethasone, Which can reduce inflammation of the spinal cord. The specific drugs used will depend on the cause; thus, if the illness is due to a virus, antivirals will be administered.
When the body does not respond properly to corticosteroids, plasma exchange therapy (plasmapheresis) may be applied, which involves removing the blood plasma and replacing it with special fluids. In this way, it is expected to eliminate the antibodies responsible for the inflammation of the spinal cord.
In addition, drugs are frequently administered to treat secondary symptoms; for example, pain relievers and muscle relaxers are used to reduce pain, And if sexual or psychic dysfunctions are present, they can prescribe specific drugs for these disorders.