Rare Classroom: Transverse Myelitis

Welcome to the Rare Classroom, a new series from Patient Worthy. Rare Classroom is designed for the curious reader who wants to get informed on some of the rarest, most mysterious diseases and conditions. There are thousands of rare diseases out there, but only a very small number of them have viable treatments and regularly make the news. This series is an opportunity to learn the basics about some of the diseases that almost no one hears much about or that we otherwise haven’t been able to report on very often.

Eyes front and ears open. Class is now in session.

The disease that we will be learning about today is:

Transverse Myelitis

What is Transverse Myelitis?

  • Transverse myelitis is a rare condition characterized by inflammation of the spinal cord
    • “Transverse” defines the inflammation as occurring horizontally across the spinal cord
    • When the full width of the spinal cord is not inflamed, the condition is called partial myelitis or partial transverse myelitis
  • This disease causes difficulties with movement, sensory issues, and weakness
  • Transverse myelitis can result in decreased electrical conductivity in the nervous system
  • The first descriptions of the signs and symptoms of the disease were made by Henry Bastian, an English neurologist, in 1882.
  • The prevalence of transverse myelitis is 4.6 per million annually.

How Do You Get It?

  • In general, the cause of transverse myelitis is unknown in many cases. However, the disease is associated with several risk factors and other illnesses.
    • It can sometimes be caused by meningococcal meningitis
    • It can also appear alongside other neurological disorders, such as multiple sclerosis and neuromyelitis optica.
    • Other immune system disorders, demyelinating diseases, and infections (particularly viral infections) can trigger the disease
    • Other potential triggers of transverse myelitis include paraneoplastic syndrome, certain vascular disorders, schistosomiasis, and spinal cord injuries
  • While transverse myelitis can appear at any age, people around age 10, age 20, and 40 years or older are at the most risk
  • Men and women are affected equally

What Are The Symptoms?

  • A number of symptoms are associated with transverse myelitis:
    • Issues with sensation and motor skills
      • “Pins and needles” sensation, often traveling up from the feet
    • Dysfunction of the urethra and anal sphincter
    • Numbness and weakness affecting the limbs
      • Just the extent and regions of the limbs affected depends on where on the spinal cord the inflammation appears
      • Respiratory failure can occur in severe cases
    • Intermittent high blood pressure
    • Back pain
  • Symptoms can develop in as little as a few hours or as slowly as a few weeks

How Is It Treated?

  • Treatment options may vary, particularly if an underlying cause is identified. When this happens, treating the underlying cause can be important.
  • Some patients can experience complete recovery if the disease is treated early
    • About a third of patients achieve
  • Plasmapheresis is a common method of treatment for transverse myelitis
  • Factors affecting recover include individual variations and the underlying cause
  • Recovery can begin two to 12 weeks following symptom onset and improvement can continue over two years
  • Some patients, about a third, never show signs of recovery. A critical factor in prognosis is whether there are signs of improvement within three to six months

Where Can I Learn More???

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