Transverse myelitis is an inflammation of the spinal cord. Its target is the insulating material covering nerve cell fibers. Transverse myelitis may result in injury in the spinal cord, affecting the senses below the injury.

The nerve signals have a disrupted transmission due to transverse myelitis, which can cause pain or other sensory problems, weakness or paralysis of muscles, or bladder and bowel dysfunction.

Transverse myelitis can be caused by everal factors, including infections and immune system disorders that attack the body's tissues. It may also occur because of other myelin disorders, such as multiple sclerosis.

Symptoms

The symptoms of transverse myelitis usually develop over a few hours and deteriorate over a few days. These are the typical:

  • Pain which begins suddenly in the neck or back which may radiate down the legs or arms or around the abdomen.
  • Abnormal sensations of numbness, tingling, coldness or burning
  • Weakness in the arms or legs even paralysis.
  • Bladder and bowel problems such as increased urinary urge, urinary incontinence, difficulty urinating and constipation.

Causes

The exact cause of transverse myelitis is not known. There are, though,  a number of conditions that appear to cause the disorder, including:

  • Viral and other infections. Viruses that can infect the spinal cord directly are herpes viruses, including the one that causes shingles and chickenpox (zoster) and West Nile virus.Rarely, parasites may infect the spinal cord.
  • Multiple sclerosis is a disorder in which the immune system destroys myelin surrounding nerves in the spinal cord and brain. Transverse myelitis can be the first sign of multiple sclerosis or represent a relapse.
  • Neuromyelitis optica (Devic's disease) is a condition that causes inflammation and loss of myelin around the spinal cord and the nerve in the eye that transmits information to the brain.
  • Autoimmune disorders such as lupus and Sjogren's syndrome.
  • Vaccinations for infectious diseases, including hepatitis B, measles-mumps-rubella, and diphtheria-tetanus vaccines, have occasionally been implicated as a possible trigger.

Risk Factors

Transverse myelitis can occur in any population at any age. Certain people with TM have a related disorder, neuromyelitis optica, which is another neurological disorder similar to multiple sclerosis that may cause severe symptoms involving the optic nerve and spinal cord. Some people with incomplete TM may develop multiple sclerosis (MS), but most patients with typical TM do not develop MS.

Complications

Patients with transverse myelitis usually experience only one acute episode. However, complications often occur:

  • Pain is one of the most common debilitating long-term complications of the disorder.
  • Stiffness, tightness or painful spasms in the muscles (muscle spasticity),
  • Partial or total paralysis of the arms, legs or both may persist after the initial onset of symptoms.
  • Sexual dysfunction.
  • Depression or anxiety, common in those with long-term complications

Prevention

If upper respiratory tract infections could be avoided, perhaps one third of all cases of transverse myelitis would be prevented. For this reason, influenza vaccinations are reasonable prophylactic measures for transverse myelitis and multiple sclerosis.