What is transverse myelitis?
Transverse myelitis is a rare neurological condition in which the entire width of the spinal cord becomes inflamed. This can cause nerve damage and pain. As a result, people with this condition can have weakness or numbness in their limbs and problems with movement.
Transverse myelitis affects males and females of all ages and races. In rare cases, transverse myelitis can be caused by vaccines, but often the cause is unknown, in which case it’s called idiopathic transverse myelitis. It can also happen from other conditions, such as viral infections or multiple sclerosis.
What are the symptoms of transverse myelitis?
Symptoms of transverse myelitis can include:
- Back pain, or shooting pain in the legs or arms or around the torso
- Weakness in the arms and legs
- Trouble with coordination
- Feelings of numbness, tingling, coldness or burning
- Bowel and bladder problems
In addition to these more common symptoms, people with transverse myelitis may have muscle spasms, headaches, fevers or loss of appetite. In rare cases this condition can cause breathing problems.
How is transverse myelitis diagnosed?
Your doctor will ask about your medical history and do a thorough neurologic examination. An important step is to rule out other conditions, such as a herniated or slipped disc, spinal stenosis, abscesses, vitamin deficiencies and others.
The following tests are used to diagnose transverse myelitis:
- Blood tests. These tests can rule out other disorders, including infections, and can also show certain antibodies found in people with transverse myelitis.
- Magnetic resonance imaging (MRI). An MRI of the spine or brain can help identify an underlying cause for transverse myelitis.
- Lumbar puncture (spinal tap). This test uses a needle to remove a small sample of spinal fluid to look for increases in proteins or other signs of infection.
How is transverse myelitis treated?
Treatments for transverse myelitis are aimed at reducing the inflammation in the spinal cord and managing symptoms, as well as treating any infection that may have caused this condition. They may include:
- Medications. Drugs can help reduce pain, treat infections or relieve complications, such as bladder problems, muscle spasms or stiffness, depression and others.
- Intravenous immunoglobulin (IVIG). This treatment uses antibodies from healthy donors to remove unhealthy antibodies from circulation.
- Intravenous (IV) corticosteroids. These drugs help decrease swelling and inflammation in the spine and also reduce immune system activity, which can contribute to inflammation.
- Plasma exchange (plasmapheresis). This procedure uses a machine to assist immune system activity by exchanging the blood plasma for certain fluids. These fluids help remove antibodies and other substances that may be causing the inflammation.
Treatments for transverse myelitis are usually given in a hospital or rehabilitation facility with a specialized medical team. People whose breathing is affected by this condition may need to be placed on a respirator.
People with this condition usually recover with only minor side effects, or none at all. A few people will have a recurrence of transverse myelitis, and in rare cases people may have permanent damage that affects their ability to do ordinary, daily tasks.
Can vaccines cause transverse myelitis?
Transverse myelitis from a vaccine is rare. However, there are several vaccines that have been linked to this condition. They include vaccines for seasonal influenza (flu shot), hepatitis B, measles mumps rubella (MMR) and diphtheria tetanus pertussis (DTP). These vaccines are included in the National Vaccine Injury Compensation Program, which helps people with vaccine injuries recover their losses.
When transverse myelitis is caused by a vaccine, the symptoms can begin from a few days up to three months after the vaccination.