Transverse myelitis is a neurological syndrome associated with damage to nerve cells in the spinal cord. In many cases, treatment with cortisone leads to almost complete rehabilitation.
What is transverse myelitis?
Transverse myelitis ( TM ) is a neurological disease associated with inflammation of the spinal cord. “Myelitis” stands for inflammation of the spinal cord and “transversal” refers to the fact that the entire cross-section of the respective spinal cord segment is affected. The inflammatory processes in the spine damage nerve cells by attacking the myelin sheath around the nerve fiber. For slang compulsion to buy, please visit electronicsencyclopedia.com.
Myelin plays an important role in the transmission of electrical signals in the central nervous system. In the case of transverse myelitis, the transmission speed is significantly reduced. TM is a relatively rare disease. Statistically, men and women are equally affected. Adolescents between the ages of 10 and 19 and adults between the ages of 30 and 49 have the highest risk of developing TM.
Causes
The cause of idiopathic transverse myelitis is unknown. It is probably an autoimmune disease. This leads to an overreaction of the immune system, in which healthy tissue is permanently damaged. Multiple sclerosis (MS) is an autoimmune disease in which the myelin sheath of nerve cells in the brain is destroyed.
In the case of transverse myelitis, a similar course of the disease could be present, but in which the nerve cells of the spinal cord are damaged. Occasionally, the condition occurs in conjunction with another condition. For example, TM can develop as a result of an infection. In rare cases, infection with pathogens such as the HIV virus, the Epstein-Barr virus, herpes zoster or the rabies pathogen leads to transverse myelitis.
Bacterial diseases such as tuberculosis, Lyme disease or syphilis are also suspected of causing TM. In addition, this neurological disease rarely occurs together with autoimmune diseases such as sarcoidosis or MS. TM can also be due to thrombosis of the spinal arteries. The spinal arteries are responsible for supplying blood to the spinal cord.
Symptoms, Ailments & Signs
The symptoms of TM are very dependent on the area of the spinal cord that is affected. Initial symptoms appear within hours to weeks of onset of the disease. In about half of those affected, the inflammation reaches its peak within the first day. Complaints arise because there are motor neurons in the spine that are no longer able to perform their work adequately.
The exchange of information between the body periphery such as the extremities and the brain is disrupted. Those affected suffer from sensory disturbances and back pain. In severe cases, functional disorders of the urinary bladder and rectum occur. The first sign of transverse myelitis is usually an increasing feeling of weakness in the legs.
Occasionally, the weakness can also occur in the arms. Loss of sensation occurs below the affected segment of the spinal cord. Numbness in the legs and trunk and reduced sensitivity to pain are typical symptoms of TM. Temperature perception is also largely changed.
Sexual dysfunctions are often observed in connection with this disease. In severe cases, the muscle weakness develops into paraplegia or spastic paralysis. In addition, patients suffer from mood swings, are exhausted and tend towards depressive moods.
Diagnosis & course of disease
At the beginning of the diagnosis, the attending physician collects a detailed anamnesis. Characteristic symptoms such as pain insensitivity in the legs can be tested, for example, by the patient’s reaction to a needle stick. After the first suspected diagnosis, magnetic resonance imaging and an examination of the spinal fluid are usually carried out.
The course of the disease depends greatly on the circumstances of the individual case. If treatment is timely, most patients make a full recovery. However, recovery is protracted and can take months to years. Some symptoms, such as a slight tingling in the legs, may remain after the inflammation has healed.
Complications
If transverse myelitis is left untreated for a long period of time, it can lead to secondary symptoms and sometimes serious complications. The disturbed exchange of information initially causes sensory disturbances and back pain. A severe course results in functional disorders of the urinary bladder and rectum.
This is accompanied by a feeling of weakness in the legs, which increases as the disease progresses and ultimately causes serious movement disorders. In isolated cases, this symptom also occurs in the arms. Due to the reduced sensitivity to pain that occurs with advanced TM, there is an increased risk of injury, since the affected person no longer properly perceives burns and hypothermia, for example.
A negative course can cause spastic paralysis up to paraplegia. Psychological complaints are also possible: mood swings, depressive moods and chronic exhaustion, for example. In the treatment of transverse myelitis, side effects from prescribed antibiotics and antivirals are possible.
Plasmapheresis carries the risk of infections and blood clotting disorders. In a few cases, injuries can also occur at the site of the puncture, or the patient has an allergic reaction to the agents and materials used.
When should you go to the doctor?
If you feel ill, feel unwell or lose physical fitness, you should consult a doctor. An increased body temperature, irritability and inner restlessness indicate an existing disease. Sensitivity disorders on the skin, irregularities in the perception of touch and a loss of muscle strength are signs of a disease. Medical examinations are necessary to clarify the cause. Changes in heart rhythm, functional disorders and irregularities in the digestive tract must be presented to a doctor.
The disease is characterized by abnormalities in the activity of the urinary bladder if the course is severe. Therefore, in these cases, you should consult a doctor immediately. If there are restrictions on movement, exhaustion, mood swings or signs of paralysis, a doctor is also needed. The person affected needs medical care in order to alleviate the symptoms. Furthermore, a visit to the doctor should be initiated if behavioral problems appear.
Depressive moods, aggressive tendencies, as well as a sharp decrease in well-being should be presented to a doctor. The physical irregularities are often concentrated in the area of the spine. If there are different temperature perceptions, numbness or sensitivity to pain, there is cause for concern and a need for action. To avoid complications or secondary diseases, a doctor should be consulted immediately.
Treatment & Therapy
Therapy should be given as soon as possible to prevent permanent damage to the nerves in the spine. The administration of cortisone -containing medication helps to dampen the excessive immune reaction and counteract the inflammation. If there is a bacterial or viral infection, antibiotics or antivirals are administered.
In some cases, plasmapheresis as part of acute therapy is promising. This is a procedure in which antibodies are selectively filtered out of the blood. In transverse myelitis, the antibodies that attack the myelin lining of the nerve fibers in the spinal cord are removed. However, this treatment is applicable only in special cases.
After successful acute therapy, the rehabilitation phase follows, in which the original physical fitness is to be restored. Coordination disorders, paralysis and muscle weakness are treated with physiotherapy. Heat applications and massages help with pain and restricted mobility.
Self-training at home is important so that the successes achieved are maintained in the long term. Depending on the severity of the disease, drug therapy may be necessary even after acute therapy and rehabilitation have taken place. This depends on the individual needs of the person concerned. Pain medication is often required.
Prevention
Targeted prevention is not possible. Late effects of bacterial or viral infections can be largely prevented if a doctor is consulted in good time. In addition, it is important to complete any therapy that has been started as prescribed and not to stop the treatment prematurely. In the case of neurological deficits such as numbness, a specialist should be consulted immediately. In many cases, this improves the prognosis of transverse myelitis.
Aftercare
In transverse myelitis, follow-up care is primarily concerned with physical rehabilitation. In this phase, the organism receives gentle support in restoring its state of health. Patients should improve their coordination and overcome muscle weakness according to the doctor’s recommendation. For this purpose, targeted physiotherapy takes place.
Massages and heat applications help against the pain and limitations caused by the illness. The later self-training following this therapy ensures long-term success and strengthens the body. In some cases, medication may be necessary to reduce the pain. Long-term rehabilitation plays a major role in the aftercare phase.
It is used to remove the functional restrictions. In connection with the neurological recovery, it is also necessary to combat psychological problems such as anxiety and depressive moods. Those affected often feel restricted in their performance and their self-confidence sinks. Intensive psychotherapy counteracts such complexes and increases self-esteem.
In order to observe the improvement in the state of health, doctors recommend keeping a complaint diary. This is not only suitable for entering symptoms such as numbness, which can indicate long-term effects. Patients should also keep accurate records of medication intake.
You can do that yourself
Transverse myelitis requires medical treatment. The most important self-help measure is to keep a complaints diary and otherwise follow the doctor’s instructions regarding the intake of medication. If complications arise, it is advisable to consult a doctor.
Transverse myelitis requires intensive rehabilitation. Important accompanying measures are physiotherapy and physical treatments. Patients can use heat and baths at home to reduce pain and disability. During neurological rehabilitation, anxiety and depression should be avoided. The people affected often feel incapable of performing and as a result also develop psychological problems. Therapeutic treatment can improve self-esteem.
The therapy also includes massages, rod baths and a wide variety of activation and relaxation treatments. These include water massages, Mediwave or treatment using bass vibrations. Self-training is essential for the success of the treatment. It is best for patients to talk to the specialist and have an individual therapy program put together, which they can carry out at home without medical support. The association Myelitis e. V. can name further measures and means and provide patients with contact points for treatment and accompanying therapy.
