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Acute transverse myelitis is a neurological disease in which the structures of the spinal cord are damaged. The consequence is, among others muscle weakness. According to the experience of doctors, most patients recover, the rest may be confined to a wheelchair or even need 24/7 assistance.

Acute transverse myelitis(acute transverse myelitis -ATM ) is a neurological disease in which, as a result of inflammation, the myelin, the sheath of nerve fibers, which is responsible for communication between the nerves in the spine and the rest of the body, is damaged. The consequence is the occurrence of motor, sensory or autonomic disorders of varying intensity.

Acute transverse myelitis affects 1-4 people out of 1 million and most often affects people between the ages of 10 and 20 and around 40.

Acute transverse myelitis - causes

This disease most often occurs in the course of an infectious disease (in almost half of the cases, 1-3 weeks earlier, an infection, usually of the upper respiratory tract, appears), an allergic process, demyelinating process or paraneoplasmic (paraneoplastic) syndrome.

Another cause of acute transverse myelitis may be systemic diseases - mainly systemic lupus erythematosus, less commonly other connective tissue diseases: Sjögren's syndrome, Behçet's disease and mixed connective tissue disease.

Other causes include spinal infarction, multiple sclerosis, and sarcoidosis. 10 percent of cases are idiopathic, meaning the cause is difficult to pin down.

Acute transverse myelitis - symptoms

The first symptoms of the disease are the suddenly appearing:

  • fever,
  • back pain,
  • pain in limbs
  • and the feeling of girdling.

Then, very quickly, because during the day, they are accompanied by symptoms of spinal cord injury, i.e. dysfunction of motor, sensory and vegetative nerves.

Paralysis of the lower limbs and dysfunction of the bladder and intestines (which are initially manifested by urinary retention andfecal incontinence) and sensory disturbances.

These are general symptoms, but in addition, there may also be those that suggest the cause of the disease:

  • symptoms suggesting infection:
    • meningeal symptoms,
    • rash,
    • coexisting general infection,
    • immunosuppression,
    • recurrent genital infections,
    • herpes zoster symptoms,
    • enlargement of the lymph nodes,
    • the occurrence of parasitic infections.
  • symptoms suggesting generalized inflammatory diseases (e.g. vasculitis, diseases of connective tissue vessels):
    • rash,
    • mouth ulcer,
    • genital ulcer,
    • enlargement of the lymph nodes,
    • marbled cyanosis,
    • serous inflammation,
    • photosensitivity,
    • arthritis,
    • erythema nodosum,
    • dry mouth,
    • keratitis,
    • conjunctivitis,
    • contractures or thickening of the skin,
    • venous or arterial thrombosis
  • symptoms suggesting Devic's disease:
    • optic neuritis and normal MRI of the brain

Acute transverse myelitis - diagnosis and treatment

To diagnose the disease, an MRI of the spinal cord and brain is performed using gadolinium (a type of contrast agent) and an analysis of the cerebrospinal fluid to rule out inflammation of the spinal cord.

Where possible, the cause of the core damage is tackled. Corticosteroids are normally administered to reduce inflammation. Symptomatic treatment is also important, e.g. painkillers and rehabilitation.

Acute transverse myelitis - prognosis

Recovery may take up to 2 years, although the greatest improvement in the patient's condition is achieved in the first 6 months from the onset of the disease. According to the experience of doctors, the condition of 1/3 of patients is so severe that they have to use a wheelchair or bed, and they need help in their daily functioning.

Relapses can occur in people with latent diseases such as multiple sclerosis or systemic lupus erythematosus.

  • Acute Relaxant Myelitis (AFM)
  • Back pain: unusual symptoms of back diseases
  • Spine - the most common diseases of the spine

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Category:

Neurology