Transverse myelitis

Also known as: TM

What is transverse myelitis?

TM is a rare inflammatory disease of the spinal cord (frequently the middle or thoracic part of the cord) that damages the protective covering (myelin) of the nerves ( both for movement and sensation) that transmit information between the brain and the rest of the body. As the inflammation spreads across the entire width of a segment of the spinal cord, it is known as transverse myelitis. TM can affect all ages, though in children the peak incidence occurs between 10-19 years.

What causes transverse myelitis? 

While the precise cause of transverse myelitis is unclear, (and in some children no cause is ever found) it seems most often to occur after another infection; bacterial, but more particularly viral infections like measles, rubella, chicken pox, influenza and mumps, among others. These, it is thought, trigger an abnormal immune inflammatory response where the body’s immune system mistakenly attacks and damages the spinal cord nerves.  In some children the spinal cord appears to be directly invaded by the infectious agent ( like poliomyelitis or herpes zoster viruses). Sometimes transverse myelitis may be part of another autoimmune disease like systemic lupus erythematosus or sarcoidosis.

What are the symptoms of transverse myelitis? 

Symptoms of transverse myelitis often begin quickly (over hours) and progress rapidly, with muscle weakness on both sides of the body, (if the upper part of the spinal cord is affected, both arms and legs are affected- if the thoracic part is affected, both legs only will be affected), back pain, limb spasticity, fatigue, and strange sensations in (depending on which part of the cord is involved) like numbness, tingling or a burning sensation may be felt in arms or feet. Almost all children will have some loss of bowel and bladder control and maximal neurological loss usually occurs within 10 days after onset. Depression symptoms are not uncommon. A few children may experience recurrent disease.

What are transverse myelitis care options? 

Treatment may include intravenous corticosteroids, plasma exchange, and other immune modulating drugs to reduce inflammation.

Reviewed by: Jack Wolfsdorf, MD, FAAP

This page was last updated on: March 20, 2019 04:00 PM