What Is Transverse Myelitis?

Transverse Myelitis is a serious neurological disorder that damages the spinal cord. Inflammation interrupts the communication between the brain and the body and can cause pain, numbness, paralysis, and other problems. Symptoms vary from person to person, and it can take a long time for doctors to make a diagnosis. There is no cure for transverse myelitis, but treatment can help lessen symptoms and improve quality of life.

What Causes Transverse Myelitis?

Transverse myelitis is an inflammatory disorder affecting the spinal cord. The exact cause is largely unknown, but it can be caused by a virus or antibody attack. Bacterial infections such as Lyme disease may also cause transverse myelitis.

TM can occur as part of other autoimmune disorders such as multiple sclerosis, neuromyelitis optica, Sjogren’s syndrome, sarcoidosis, and systemic lupus erythematosus.

The trigger event for transverse myelitis is usually a lesion in the spinal cord. This damages the insulating material around the nerve cell fibers (myelin). The damage causes interruptions to the messages that the spinal cord sends out to the body. This can lead to a wide variety of symptoms depending on the location of the affected vertebrae and the extent of the damage.

How Common is Transverse Myelitis?

Conservatively, TM is a rare disease estimated to affect between one and eight people out of every million; working out to approximately 1400 cases per year.

Signs and Symptoms of Transverse Myelitis

Because the symptoms can be so varied, it can often be difficult for doctors to diagnose transverse myelitis accurately. There is no cure for transverse myelitis, but there are treatments available that can help lessen symptoms and improve quality of life.

Signs of spinal cord injury and symptoms of transverse myelitis vary from person to person and can change over time. Signs may include:

• tenderness near the vertebrae
• pain and stiffness in other parts of the body
• body fatigue

Other transverse myelitis symptoms can include:

• chronic pain
• muscle weakness in the arms and/or legs
• numbness or tingling
• changes in bowel or bladder function
• severe weakness or paralysis
• sexual dysfunction

Many people with transverse myelitis also experience fatigue, emotional changes, and cognitive problems. Transverse myelitis symptoms can be quite disabling, and can significantly affect the quality of life. Early diagnosis and treatment can make a big difference in the long-term outcome of the disease.

How is Transverse Myelitis Diagnosed?

Diagnosis of transverse myelitis usually involves an analysis of medical history and a combination of tests, including:

• a lumbar puncture (spinal tap) to measure the level of white blood cells in the spinal fluid
• magnetic resonance imaging (MRI) scan to look for damage to the spinal cord
• blood tests to look for signs of inflammation
• a urine test to check for abnormalities in the urine

Transverse myelitis occurs most commonly in young adults but can be diagnosed at any age. There is no definitive test for transverse myelitis, and it can take some time for doctors to make a diagnosis. Due to the range of symptoms, it’s important to have a thorough evaluation by a doctor who is familiar with the condition.

Treatments for Transverse Myelitis

How transverse myelitis is treated depends on the person’s symptoms and how severe the diagnosis is. Medications can help lessen pain, reduce spinal cord inflammation and other symptoms. Surgery may be needed if someone has problems with bladder control or bowel dysfunction.

Some people with transverse myelitis may need to use a wheelchair or other assistive device to get around. There is no cure for transverse myelitis, but treatments can help lessen symptoms and improve quality of life. With time and patience, many people with transverse myelitis learn to manage their symptoms and live relatively normal lives.

Physical Therapy

Physical therapy can help people regain movement and strength. Physical therapists will work with you to create a program that meets your needs.

Occupational Therapy

Occupational therapy can help people learn new ways to do things they used to do before they developed transverse myelitis. For example, an occupational therapist can help you learn how to dress if you have trouble using your arms or legs.

Intravenous Steroids

Intravenous steroid treatment is often used in acute transverse myelitis for its anti-inflammatory properties.

Plasmapheresis

Plasmapheresis, or plasma exchange therapy, is a procedure that removes plasma from the blood and replaces it with other fluids. This procedure can help reduce inflammation in the body if steroids didn’t work.

Cyclophosphamide

Cyclophosphamide is a medication typically used to treat various types of cancer. It can be used to treat transverse myelitis by suppressing cell growth and the immune system.

OTC Pain relievers

Store-bought pain medicines like acetaminophen, ibuprofen, and naproxen can be used to help ease severe muscle pain.

Muscle Relaxers

Prescription muscle relaxers can also be used to help manage pain. These should only be used as directed by a doctor.

Antidepressants

Antidepressant drugs can be prescribed for nerve pain along with the prevalence of clinical depression among transverse myelitis patients.

Bladder Care

People with transverse myelitis may need to take special steps to keep their bladder healthy. This may include using a catheter to empty the bladder or taking medications to help reduce urinary frequency.

Bowel Management

People with transverse myelitis may need to take special steps to keep their bowel function healthy. This may include taking medications to help reduce constipation or using a suppository to stimulate bowel movements.

Nutritional Counseling

People with transverse myelitis may need to meet with a dietitian to discuss their nutritional needs. This is especially important if transverse myelitis has caused weight loss or problems with swallowing.

Vocational Rehabilitation

If transverse myelitis has caused someone to lose their job, they may need to meet with a vocational rehabilitation counselor to discuss their options. This may include job training or education to help them find a new job.

Psychological Counseling

People with transverse myelitis may need to meet with a psychologist or counselor to help deal with the emotional effects of the condition. This may include anxiety, depression, or adjustment disorder.

Can You Recover from Transverse Myelitis?

Recovery from transverse myelitis varies from person to person, depending on the extent of damage to the spinal cord. Some people have a single episode and make a full recovery, while others experience long-term disabilities.

Early diagnosis and treatment are essential for the best possible outcome.

What is the Difference Between Transverse Myelitis and Multiple Sclerosis?

Both transverse myelitis and multiple sclerosis are autoimmune diseases that can damage the spinal cord, but there are some key differences between them.

Multiple Sclerosis is a more common disease affecting the central nervous system. MS is rarely fatal and severe symptoms are not common.

Transverse myelitis, on the other hand, is a much rarer disease. TM occurs solely in the spinal cord and tends to cause more severe symptoms than multiple sclerosis.

With both transverse myelitis and MS involving damage to the spinal cord, sometimes transverse myelitis can be a precursor to multiple sclerosis if the inflammation or lesions also develop in the brain.

Where Can I Get More Information?

• Johns Hopkins Transverse Myelitis Center
• SRNA – Siegel Rare Neuroimmune Association (formerly known as the Transverse Myelitis Association)
• National Multiple Sclerosis Society
• Christopher & Dana Reeve Paralysis Resource Center
• American Chronic Pain Association

If you or someone you know is suffering from transverse myelitis, please know that you are not alone. There is support available, and treatments are available to help lessen symptoms and improve quality of life. We hope this article has provided you with a better understanding of transverse myelitis.