CONDITIONS

Transverse myelitis

Transverse myelitis is a neurological condition that happens when both sides of the same section of the spinal cord become inflamed. This inflammation can damage myelin, the fatty substance that covers your nerves. Loss of myelin often leads to spinal cord scarring that blocks nerve impulses and results in physical problems.

Transverse myelitis is a relatively rare disease. It occurs most often in children ages 10 to 19 and in adults ages 30 to 39, but it can happen at any age.

Causes

Experts don’t know the exact cause of transverse myelitis. The inflammation that leads to transverse myelitis can result as a side effect of a number of other conditions, including:

• Lyme disease
• Syphilis
• Measles
• Viral infections
• Bacterial infections

Some people may also get transverse myelitis as a result of spinal injuries, spinal defects, or vascular diseases like atherosclerosis, all of which can reduce the amount of oxygen in spinal cord tissue.

If parts of the spinal cord don’t have enough oxygen, nerve cells often start to die. The dying tissue can cause the inflammation that leads to transverse myelitis.

Transverse myelitis can also be a warning sign of multiple sclerosis, but this is rare. Since some people with transverse myelitis have autoimmune diseases such as lupus, some doctors believe that transverse myelitis may also be an autoimmune disease. Finally, some cancers can trigger an immune response that leads to transverse myelitis.

Symptoms

The symptoms of transverse myelitis can develop over several hours or days, or over a longer period of 1 to 2 weeks. These are possible symptoms:

• Back or neck pain
• Weakness in arms or legs
• Abnormal feelings in the legs, such as burning, tingling, or pricking
• Loss of bladder or bowel control
• Heightened sensitivity to touch

Where in the body these symptoms occur depends on what part of the spinal cord is inflamed. People with inflammation in the neck typically feel symptoms from the neck down, while inflammation in the middle of the spine can cause symptoms from the waist down.

Diagnosis

If you suspect that you have transverse myelitis, your healthcare provider will likely review your medical history and do a complete physical exam. Because transverse myelitis can be caused by a number of treatable conditions, your provider may want to test for some of those diseases. One test you might need is a CT or MRI scan.

Another common test is myelography, a procedure in which a needle is used to inject a special dye into your spinal area. A technician will then use a real-time X-ray called fluoroscopy to get pictures of your spinal cord.

Blood tests and a lumbar puncture (spinal tap) may also be done to rule out other causes for transverse myelitis.

If all potential underlying causes of transverse myelitis have been ruled out, it is called idiopathic.