What do Doctors call this Condition - Myelitis, acute transverse myelitis

What is this Condition?

Inflammation of the spinal cord can result from several diseases. Poliomyelitis, one form of spinal cord inflammation, affects the cord’s gray matter and produces motor dysfunction; leukomyelitis affects only the white matter and produces sensory dysfunction.

Acute transverse spinal cord inflammation, which affects the entire thickness of the spinal cord, produces both motor and sensory dysfunctions. This condition develops rapidly and is the most devastating type of spinal cord inflammation.

The prognosis depends on the severity of cord damage and prevention of complications. If spinal cord tissue death occurs, the prognosis for complete recovery is poor. Even without tissue death, residual nervous system deficits usually persist after recovery.

What Causes it?

Acute transverse spinal cord inflammation has many causes. It often follows acute infectious diseases, such as measles or pneumonia (the inflammation occurs after the infection has subsided), and primary infections of the spinal cord itself, such as syphilis or acute disseminated encephalomyelitis. Acute transverse spinal cord inflammation can accompany demyelinating diseases, such as acute multiple sclerosis, and inflammatory and necrotizing disorders of the spinal cord, such as hematomyelia.

Certain toxic agents (carbon monoxide, lead, and arsenic) can cause a type of spinal cord inflammation in which acute inflammation (followed by hemorrhage and possible necrosis) destroys the entire circumference of the spinal cord.

Other forms of spinal cord inflammation may result from poliovirus, herpes zoster, herpesvirus B, or rabies virus.

What are its Symptoms?

In acute transverse spinal cord inflammation, onset is rapid, with motor and sensory dysfunctions below the level of spinal cord damage appearing in 1 to 2 days.

People with acute transverse spinal cord inflammation develop flaccid paralysis of the legs (sometimes beginning in just one leg) with loss of sensory and sphincter functions. Such sensory loss may follow pain in the legs or trunk. Reflexes disappear in the early stages but may reappear later. The extent of damage depends on the level of the spinal cord affected; transverse spinal cord inflammation rarely involves the arms. If spinal cord damage is severe, it may cause shock.

How is it Diagnosed?

Paraplegia (paralysis of both legs) that develops suddenly usually points to acute transverse spinal cord inflammation. In these people, a neurologic exam confirms paraplegia or neurologic deficit below the level of the spinal cord lesion and also shows absent or, later, hyperactive reflexes. Cerebrospinal fluid may be normal or show increased lymphocytes or elevated protein levels.

Diagnostic evaluation must rule out spinal cord tumor and identifY the cause of any underlying infection.

How is it Treated?

No effective treatment exists for acute transverse spinal cord inflammation. However, this condition requires appropriate treatment of any underlying infection. Some people with postinfectious or multiple sclerosis-induced spinal cord inflammation have received corticosteroid therapy, but its benefits aren’t clear.