What is Transverse Myelitis?
Transverse myelitis is a rare neurological condition where the spinal cord becomes inflamed. The Transverse aspect implies that the inflammation of the spine extends across the entire width of the spinal cord, whereas myelitis refers specifically to the inflammation of the spinal cord. Partial transverse myelitis and partial myelitis are also frequently used terms that describe the inflammation of the spinal cord, and the width affected. Transverse myelitis is typically characterized through signs of neurologic dysfunction in motor and sensory tracts along both sides of the spinal cord. Typically, those affected by transverse myelitis experience weakness or numbness in the limbs and a decline in sensation and motor skills. In addition, those affected may completely lose sensation or experience sensory changes as a result of the transverse myelitis interrupting messages from the spinal cord nerves. This can lead to pain, muscle weakness, paralysis, and even bladder or bowel dysfunction.
What causes Transverse Myelitis?
There are many causes for transverse myelitis including infections or other immune system disorders that weaken or attack the body’s tissues. Transverse myelitis may also be caused by other spinal related disorders, including multiple sclerosis or it can be idiopathic, meaning that the cause itself is unknown. Though, in the idiopathic setting of transverse myelitis, this is more likely an outcome of failing to recognize the causative factors before they disappear and are replaced by transverse myelitis. This could occur as a result of viral infections, or post-infectious disorders. Transverse myelitis does not affect any particular segment of the population more than another. Instead, it strikes all age groups, genders, and races. In younger patients, transverse myelitis may also be a first indicator of other disorders, including multiple sclerosis or neuromyelitis optica. Some patients may also be misdiagnosed with transverse myelitis as a result of a spinal cord stroke or vascular myelopathy, which may lead to ineffective treatment approaches.
What are the symptoms of Transverse Myelitis?
When transverse myelitis occurs it does so in either an acute manner, where it develops over the course of hours or several days, or in a subacute manner, where the disease manifests over the course of one to four weeks. During this onset period, the key symptoms that distinguish transverse myelitis from many other vaccine-related injuries are the following:
- Weakness of arms and legs: Since transverse myelitis attacks the spinal cord, some individuals may only develop paraparesis (partial paralysis of the legs), while others develop full paralysis. This particularly occurs if the condition affects the lower part of the spinal cord. In instances where the myelitis affects the upper spinal cord, an individual may experience loss of sensation and/or motor function in the arms as well.
- Pain: When an individual is first impacted by myelitis, the initial symptoms are typically pain in the area of the back where the myelitis is located as well as sharp and shooting sensations that run down the legs or arms or through the torso.
- Sensory alterations: In addition to paralysis transverse myelitis can lead to a decline in sensation. This results in abnormal burning, tickling, pricking, numbness, or even coldness and tingling.
- Bowel and bladder discomfort: For some, common symptoms of transverse myelitis can include an increased need or urge to use the toilet, incontinence, hesitancy, as well as constipation.
In addition to these classic symptoms, those affected by transverse myelitis may also experience muscle spasms, general discomfort, headaches, fevers, loss of appetite, and in rare cases respiratory problems.
How is Transverse Myelitis diagnosed?
Transverse myelitis is typically diagnosed through a neurological examination, following a full evaluation of a patient’s medical history. The next step is to rule out a series of conditions that may require further intervention. Throughout the evaluation process, your physician will also likely identify whether you’ve been affected by a herniated or slipped disc, spinal stenosis, abscesses, abnormal collections of blood vessels, and vitamin deficiencies. There are several tests that may be used to diagnose transverse myelitis or rule out another potential underlying cause of symptoms. These include the following:
Magnetic Resonance Imaging (MRI): In some instances, a spinal MRI may be used to confirm the presence of a lesion within the spinal cord. Alternatively, a brain MRI may be used to in an attempt to identify the underlying cause of transverse myelitis. Often times an injection of a contrast agent is given during the exam to determine whether the contrast agent is leaking out from the spinal cord. In such an instance, the leak would be indicative of inflammation in the spinal cord.
Blood Tests: A blood test may be used to identify various disorders, such as HIV infection, vitamin B12 deficiency, as well as many others. In particular, when diagnosing transverse myelitis, the blood is tested for the presence of autoantibodies, as well as a host of antibodies that are closely associated with cancer, which may be found in those affected by transverse myelitis.
Lumbar puncture: This is when a needle is used to remove a small sample of the spinal fluid that surrounds the brain and spinal cord. For some patients with transverse myelitis, this spinal fluid will contain more protein than normal, as well as an increase in the white blood cell count. This is one of those most important ways to identify an infectious cause.
How is Transverse Myelitis treated?
Treatments for transverse myelitis are primarily focused at addressing infections that may have caused the disorder, as well as reducing spinal cord inflammation and managing or alleviating symptoms. Initial treatments for transverse myelitis focus on the complications of the disease. This may include intravenous corticosteroids, which assist in decreasing the swelling and inflammation occurring in the spine, as well as aim to reduce immune system activity. For those who experience no relief or respond poorly to intravenous steroids, plasma exchange therapy may also be a treatment option. This procedure reduces immune system activity by exchanging the plasma for special fluids, which help to remove the antibodies and other potential causes of the inflammatory reaction. Other potential treatments for transverse myelitis include intravenous immune globulin therapy which uses a highly concentrated injection of antibodies collected from healthy donors. Ideally, through this treatment, the injected antibodies will bind to the antibodies that cause the disorder, and eventually remove them from circulation. Some of the more standard treatments for transverse myelitis are aimed at alleviating many of the symptoms, which includes pain medicines, antiviral medications for those with viral spinal infections, or medications that are aimed at treating some of the other complications associated with transverse myelitis, including incontinence, tonic spasms, stiffness, sexual dysfunction, and depression.
For most, following the initial treatment, it is critical to keep the body functioning while it makes either a complete or partial recovery of the nervous system. This may mean that a person will be placed on a respirator if breathing is affected; but for the most part, treatment is given in a hospital or rehab facility with a specialized medical team that is there to prevent or treat future problems that affect paralyzed individuals. Generally, patients affected by transverse myelitis typically recover with minor or no residual problems, although in some rare cases patients may suffer permanent damage that affects their ability to perform ordinary daily tasks. Most patients will also only have one episode of transverse myelitis in their lifetime, though a small percentage of patients may have a recurrence.
Transverse Myelitis compensation
In most instances of transverse myelitis resulting from a vaccine, the symptoms began to manifest anywhere from several days to up to three months after the vaccination. While rare, there are several vaccines, including seasonal influenza, hepatitis B, MMR, and DTP, that have been linked to transverse myelitis; however, this is a very rare condition. According to the National Institute of Health, only about 1,400 cases of transverse myelitis are diagnosed each year. If you believe that you have been affected then it is critical to see your physician and begin the diagnosis process.
Since in rare instances vaccines may cause transverse myelitis, those affected by transverse myelitis after a vaccination may be able to seek redress through the National Vaccine Injury Compensation Program. There are specific eligibility requirements that must be met in order to file a claim for vaccination injury under this special government program. To find out if you or a loved one qualifies to file vaccine injury claim contact one of our qualified legal professionals today.
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