Transverse Myelitis

It is a severe nervous system disorder where electrical signaling sent by nerves to the body is disrupted due to the transverse inflammation across a specific segment of the spinal cord.

Although the exact etiology often remains idiopathic, the most common triggers include autoimmune-mediated attacks on the spinal cord following viral/bakterial infections, or established autoimmune conditions such as Multiple Sclerosis (MS) and Neuromyelitis Optica (NMO).

Symptoms can evolve rapidly within hours, presenting with sudden-onset severe low back or thoracic pain, paresthesias/numbness in the lower extremities and feet, ambulation difficulties (motor weakness), and fecal or urinary incontinence (loss of bladder control).

MS is a chronic disorder that typically presents with relapses and involve both the brain and the spinal cord. Conversely, transverse myelitis generally manifests as a solitary, severe acute episode isolated exclusively to the spinal cord without encephalic involvement.

Following clinical neurological examination assessing reflexes and motor strength, a Contrast-Enhanced Spinal MRI is performed, clearly visualizing the intraparenchymal spinal cord inflammation. Furthermore, a lumbar puncture is completed to analyze cerebrospinal fluid (CSF) to differentiate from MS or primary infectious pathogens.

Immediately upon diagnosis, Intravenous High-Dose Corticosteroids (IV methylprednisolone) or therapeutic plasmapheresis (plasma exchange) are instituted to arrest neuro-inflammation. A significant majority of patients recover partial or complete ambulatory function following months of intensive physical therapy and neurological rehabilitation.