Transverse myelitis: what is it, symptoms, causes and treatment

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 symptoms and main causes and how it can be treated.

• Related article: "Myelin: definition, functions and characteristics"

What is transverse myelitis?

Myelitis are diseases that consist of inflammation of the spinal cordwhether this is the cause of the patient's symptoms or a consequence of another central nervous system disorder.

The name “myelitis” comes from the fact that they are frequently affected nerve fibers covered with myelin sheaths, a substance that insulates axons and facilitates the transmission of electrochemical impulses between neurons.

“Transverse myelitis” is the term used for this disease when inflammation occurs on both sides of a section of spinal cord. We speak of partial transverse myelitis when the inflammation extends to both sides of the spinal cord but incompletely.

Damage is usually limited to a small area of ​​the spinal cord., although the severity of myelitis varies depending on the case. The interruption in the sending of signals along the spinal cord causes alterations and physical deficits of various kinds.

• Related article: "The 15 most common neurological disorders"

Main symptoms and signs

Symptoms of transverse myelitis usually affect both sides of the body below the damaged section of spinal cord. Although in general the development of these symptoms occurs in a matter of hours or days, sometimes it is slower, and it may take weeks to fully evolve.

1. Pain

In many cases, transverse myelitis is detected by the sudden appearance of severe, stabbing pains in the lower back and legs. Depending on the part of the spinal cord affected, pain may occur in other parts of the body, such as the chest and abdomen.

• Related article: "Chronic pain: what it is and how it is treated from Psychology"

2. Muscular weakness

Muscle weakness typically affects the legs, causing feelings of heaviness in the lower extremities and difficulty walking. If the damaged section is located in an elevated part of the cord, weakness can also occur in the arms.

3. Paralysis

In the context of transverse myelitis, muscle paralysis occurs as a progression of limb weakness, particularly in the legs. When the paralysis is partial we speak of paraparesis, while if it is complete the correct term is paraplegia.

4. sensory disturbances

Abnormal sensations that may occur as a result of myelitis include tingling, numbness, itching, burning, and sensitivity to intense heat and cold. The body parts commonly affected are the legs, torso, and genitals. Sensory deficits are also common.

5. sphincter dysfunction

Alteration in the function of the bladder and intestines It manifests itself in the presence of urinary incontinence, difficulties in urinating and defecating, and constipation.

Causes of this disease

Most cases of transverse myelitis occur as a result of disorders that affect 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 abnormalities that are associated with spinal cord inflammation. Between these postinfectious and postvaccinal reactions stand out and the multiple sclerosis, to which we devote a separate section.

Transverse myelitis can also occur as a consequence of autoimmune disorders such as systemic lupus erythematosus, neuromyelitis optica, and Sjogren's syndrome.

2. Multiple sclerosis

Multiple sclerosis is a particularly common immune disorder that causes the destruction of the myelin sheaths that wrap 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

Virus infections are a common cause of transverse myelitis, which usually occurs during the recovery period. Herpetic viruses such as chickenpox and cytomegalovirus are some of the most common in this regard.

In addition, infections with bacteria (such as syphilis and tuberculosis), fungi (such as cryptococci), and parasites (such as toxoplasmosis) can also cause inflammation of the marrow. However, this problem is more common in viral infections.

4. Other inflammatory diseases

Systemic lupus erythematosus, mixed connective tissue disease, sarcoidosis, scleroderma, syndrome Sjogren's, among other diseases, can also cause inflammation in the nerve fibers of the spinal cord spinal. 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 subside within weeks, although they can take up to two years to resolve completely. The prognosis is worse if there is no improvement after about five months of treatment.

Treatment of transverse myelitis usually consists of the administration of medications combined 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 most commonly used drugs in the treatment of myelitis are intravenous corticosteroids such as methylprednisolone and dexamethasone, which can reduce inflammation of the marrow. The specific medications used will depend on the cause; thus, if the disease is due to a virus, antivirals will be administered.

When the body does not respond adequately to corticosteroids, corticosteroid therapy can be applied. plasma exchange (plasmapheresis), which involves removing blood plasma and replacing it with fluids specials. In this way, it is intended to eliminate the antibodies responsible for the medullar inflammation.

In addition, drugs are frequently administered to treat secondary symptoms; for example, pain relievers and muscle relaxants are used to reduce pain, and if sexual or mood dysfunctions are present, specific medications can be prescribed for these alterations.