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Transverse Myelitis: Causes, Symptoms, Treatment, and Cost

Last Updated: Feb 28, 2023

What is Transverse Myelitis?

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A uncommon neurological disorder called transverse myelitis damages the spinal cord and causes inflammation that harms the white matter (myelin) of the spinal cord. As a result, the brain and the rest of the body are unable to communicate properly, which causes a variety of symptoms such as muscle weakness, lack of feeling, discomfort, and problems with the bladder and bowels.

What are the types of Transverse Myelitis?

Transverse Myelitis can be classified into several different types based on its underlying cause and the pattern of symptoms. The following are the most commonly recognized types of Transverse Myelitis;

Acute Transverse Myelitis

This type of Transverse Myelitis occurs suddenly, often in the aftermath of a viral illness or other infection, and typically results in severe symptoms that develop rapidly over the course of a few days.

Subacute Transverse Myelitis

This type of Transverse Myelitis is characterized by a more gradual onset of symptoms, which may evolve over the course of several weeks or months.

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Chronic Transverse Myelitis

If symptoms last longer than three months, it is diagnosed as Chronic Transverse Myelitis. This may be the result of a number of underlying conditions, including multiple sclerosis, neuromyelitis optica, or a persistent autoimmune disorder.

Recurrent Transverse Myelitis

This type of Transverse Myelitis is characterized by multiple episodes of inflammation in the spinal cord, each leading to a new episode of symptoms.

Devic’s Disease

This is a specific type of Transverse Myelitis that is associated with the development of optic neuritis and other symptoms related to the central nervous system.

It is important to note that Transverse Myelitis can be associated with a variety of underlying conditions, including multiple sclerosis, neuromyelitis optica, and autoimmune disorders, among others.

Additionally, the symptoms and course of Transverse Myelitis can vary greatly from person to person, making it difficult to predict the outcome for any individual.

What causes Transverse Myelitis?

The exact cause of Transverse Myelitis is unknown, but it is thought to be the result of an autoimmune reaction, where the body’s immune system mistakenly attacks healthy tissue in the spinal cord. Other potential causes include viral or bacterial infections, neuroinflammation, or a direct injury to the spinal cord.

What are the symptoms of Transverse Myelitis?

Individuals with Transverse Myelitis can experience a wide range of symptoms, which can vary greatly depending on the severity and location of the inflammation.

The following are some of the most common symptoms of Transverse Myelitis;

  • Muscle weakness or paralysis in one or more limbs
  • Loss of sensation, including numbness or tingling in the legs, arms, or torso
  • Pain in the back, legs, or arms
  • Bladder and bowel dysfunction, including difficulty urinating or having bowel movements
  • Sexual dysfunction
  • Difficulty standing or walking
  • Problems with coordination and balance
  • Fatigue
  • Depression or anxiety
  • Changes in mood or behavior

It's important to note that not all individuals with Transverse Myelitis will experience all of these symptoms, and the severity and duration of symptoms can vary greatly from person to person. Additionally, some individuals with Transverse Myelitis may experience only mild symptoms, while others may experience severe symptoms that significantly impact their quality of life.

Who does transverse myelitis affect?

Any age, gender, or race can be afflicted by the disorder known as transverse myelitis. Although the specific cause is uncertain, immune system attack on the spinal cord is thought to be the cause of transverse myelitis. Most cases of transverse myelitis are detected in people between.

The condition is more common in females than in males, and is more likely to occur in individuals with a history of autoimmune disorders or other neurological conditions. Although the actual prevalence of transverse myelitis is unknown, it is estimated to affect approximately one in every million people each year.

While the condition can have a significant impact on an individual's quality of life, with proper diagnosis and treatment, many individuals with Transverse Myelitis are able to make a full or partial recovery.

What are the Risk Factors of Transverse Myelitis?

Although the precise cause of transverse myelitis is not yet established, there are a number of known risk factors that may make someone more likely to get the disease.

The following are some of the most commonly recognized risk factors for Transverse Myelitis;

  • Age: Transverse Myelitis can occur at any age, but is most commonly diagnosed in individuals between the ages of 15 and 50.
  • Gender: Compared to men, women have a slightly higher risk of developing transverse myelitis.
  • Infections: Varicella zoster virus, Epstein-Barr virus, and Lyme disease are among the viral and bacterial infections that have been related to the emergence of Transverse Myelitis.
  • Immunological disorders: Individuals with autoimmune disorders, such as multiple sclerosis, lupus, or rheumatoid arthritis, may be at an increased risk of developing Transverse Myelitis.
  • Family history: A family history of Transverse Myelitis or other autoimmune disorders may increase an individual's risk of developing the condition.

How can you prevent Transverse Myelitis?

Transverse Myelitis is a complex condition that can have a significant impact on the quality of life of those affected. There are some steps that individuals can take to reduce their risk of developing the condition and to promote overall spinal cord health;

Do

  • Maintain good hygiene: Regular hand washing and avoiding close contact with individuals who are sick can help reduce your risk of exposure to infections that have been linked to Transverse Myelitis.
  • Exercise regularly: Regular physical activity can help maintain overall spinal cord health and reduce the risk of developing Transverse Myelitis.
  • Manage stress: A higher risk of autoimmune diseases, including Transverse Myelitis, has been associated with long-term stress. You can lower your risk of getting the illness by partaking in stress-relieving activities like yoga, meditation, or physical activity.
  • Get vaccinated: Some infections that have been linked to Transverse Myelitis, such as varicella zoster virus, can be prevented through vaccination.

Don’t

  • Smoke: An increased risk of autoimmune diseases, including Transverse Myelitis, has been associated with smoking. You can lessen your risk of having the illness by giving up smoking or by staying away from areas where there is a chance of passive smoking.
  • Ignore symptoms: If you experience any symptoms of Transverse Myelitis, it's important to seek prompt medical attention. Early intervention can lessen symptom intensity and avert long-term consequences.

Transverse Myelitis - Diagnosis and Tests

In order to accurately diagnose Transverse Myelitis, healthcare providers typically use a combination of medical history, physical examination, and diagnostic tests.

Magnetic Resonance Imaging (MRI)

MRI is a non-invasive imaging test that uses a strong magnetic field and radio waves to create detailed images of the spinal cord. MRI can help healthcare providers identify areas of inflammation and damage to the myelin in the spinal cord, which are common signs of Transverse Myelitis.

Spinal Tap (Lumbar Puncture)

A spinal tap involves removing a small sample of cerebrospinal fluid (the fluid that surrounds the spinal cord and brain) for analysis. This test can help healthcare providers determine if there is an infection or other underlying condition that may be causing the symptoms of Transverse Myelitis.

Nerve Conduction Studies

Nerve conduction studies are tests that measure the electrical impulses of nerve signals in the body. These tests can help healthcare providers determine if there is any damage or disruption to the nerve impulses, which is a common symptom of Transverse Myelitis.

Electromyography (EMG)

EMG records the electrical activity of the muscles. This test can help healthcare providers determine if there is any damage or disruption to the nerve impulses that control muscle movement, which is a common symptom of Transverse Myelitis.

Physical Examination

A physical examination is a key component of the diagnostic process for Transverse Myelitis. Your muscular tone, sensitivity, reflexes, and coordination will be evaluated by medical professionals during a physical examination. These assessments can help healthcare providers determine the location and severity of the inflammation in the spinal cord and make a more accurate diagnosis of Transverse Myelitis.

It's important to note that there is no single test that can definitively diagnose Transverse Myelitis. Healthcare providers will typically use a combination of tests and assessments to make an accurate diagnosis, and may need to perform additional tests over time to monitor the progression of the condition and evaluate the effectiveness of any treatments.

What are possible complications of Transverse Myelitis?

While the majority of individuals with Transverse Myelitis recover with proper treatment, there are a number of possible complications that can arise, including:

  • Chronic pain: Chronic pain is a common complication of Transverse Myelitis, as the inflammation and damage to the spinal cord can cause ongoing pain and discomfort.
  • Mobility issues: Individuals with Transverse Myelitis may experience difficulty with walking, balance, and coordination, which can result in mobility issues.
  • Bowel and bladder issues: Incontinence, constipation, and other related issues are possible side effects of transverse myelitis that might damage the nerves that regulate bowel and bladder function.
  • Sexual dysfunction: Transverse Myelitis can affect the nerves that control sexual function, leading to sexual dysfunction, including decreased libido and difficulty with achieving and maintaining an erection.
  • Psychological and emotional impact: The physical and mobility issues associated with Transverse Myelitis can also have a significant psychological and emotional impact, including depression, anxiety, and decreased quality of life.

It's important to note that not all individuals with Transverse Myelitis will experience these complications, and the severity and duration of these complications can vary depending on the individual and the severity of the condition. With proper treatment and management, many individuals with Transverse Myelitis are able to recover and live full and productive lives.

Home Remedies for Transverse Myelitis?

Along with proper medical treatment for managing Transverse Myelitis, there are also a number of home remedies that can help individuals cope with the symptoms and improve their overall quality of life. Some of these remedies include;

  • Heat therapy: Applying heat to the affected area, such as through a warm bath or heating pad, can help relieve pain and muscle spasms associated with Transverse Myelitis.
  • Gentle exercise: Gentle exercise, such as yoga or physical therapy, can help maintain muscle strength, flexibility, and mobility, and can also help relieve stress and anxiety.
  • Good posture: Maintaining good posture can help prevent strain on the spinal cord and reduce pain associated with Transverse Myelitis.
  • Adequate hydration: Staying hydrated by drinking plenty of water and other fluids can help relieve constipation and other bowel and bladder issues associated with Transverse Myelitis.
  • Healthy diet: Eating a nutritious, balanced diet full of vitamins, minerals, and antioxidants helps boost general health and increase the body's capacity to handle Transverse Myelitis symptoms.

These home remedies can be helpful in managing the symptoms of Transverse Myelitis, but they should not be used as a substitute for proper medical treatment.

What to eat in Transverse Myelitis?

A healthy diet can play an important role in managing the symptoms of Transverse Myelitis and supporting overall health. Following are a few food suggestions for those with transverse myelitis;

  • Eat a lot of fruits and vegetables: Fruits and vegetables are packed with vitamins, minerals, and antioxidants that can improve general health and decrease inflammation.
  • Lean protein: Maintaining muscle mass and promoting general health depend on getting enough protein. To reduce inflammation, use lean protein sources like chicken, fish, and lentils.
  • Whole grains: Whole grains are a good source of fiber, vitamins, and minerals that can help regulate digestion and ward off constipation. Examples of whole grains are brown rice and whole grain bread.
  • Hydration: Staying hydrated by drinking plenty of water and other fluids can help relieve constipation and other bowel and bladder issues associated with Transverse Myelitis.

It's essential to eat a balanced diet that meets your nutritional needs and supports overall health, as this can play an important role in managing the symptoms of Transverse Myelitis.

What not to eat in Transverse Myelitis?

While a healthy diet can help manage the symptoms of Transverse Myelitis, there are also certain foods that should be limited or avoided.

Some dietary recommendations for individuals with Transverse Myelitis include;

  • Processed foods: Processed foods are among the items to avoid if you have transverse myelitis. Processed foods, such fast food, processed meats, and sweet snacks, are inflammatory because they are heavy in salt, sugar, and bad fats.
  • Fried foods: Fried foods, such as french fries and fried chicken, are high in unhealthy fats and can contribute to inflammation.
  • High-fat dairy products: High-fat dairy products, such as whole milk and cheese, are high in saturated fat, which can contribute to inflammation.
  • Alcohol: Alcohol can interfere with the proper functioning of the spinal cord and should be limited or avoided by individuals with Transverse Myelitis.

Transverse Myelitis Treatments

The severity and persistence of the symptoms, as well as the underlying etiology of the ailment, all affect how Transverse Myelitis is treated. A variety of therapies are accessible to help manage the symptoms and enhance general quality of life.

Some common treatments for Transverse Myelitis include;

Medical Treatments

  • Corticosteroids: Corticosteroids are powerful anti-inflammatory drugs that can help reduce inflammation in the spinal cord and relieve symptoms.
  • Plasmapheresis: Plasmapheresis is a procedure that removes plasma (the liquid part of the blood) and replaces it with a different fluid to help remove harmful substances from the body.
  • Immunoglobulin Therapy: Immunoglobulin therapy helps to strengthen the immune system by injecting immunoglobulin, a blood protein, into the bloodstream.
  • Physical Therapy and Rehabilitation

    Physical therapy and rehabilitation can help improve strength, flexibility, and coordination, as well as manage chronic pain and other symptoms associated with Transverse Myelitis.

    Occupational therapy can help improve fine motor skills and help individuals with Transverse Myelitis regain independence and perform daily activities.

    Alternative Therapies

    • Acupuncture: In order to ease pain and enhance general health, acupuncture is a traditional Chinese technique that involves inserting tiny needles into particular places on the body.
    • Massage therapy: Massage therapy can help relieve muscle tension and improve circulation, which can help manage pain and other symptoms associated with Transverse Myelitis.

    The ideal course of action for your particular demands will depend on you as an individual, thus it's crucial to keep in mind that the most successful treatment strategy will vary depending on the patient.

    Which doctor to consult for Transverse Myelitis?

    • Transverse Myelitis symptoms should be reported as soon as possible to a healthcare professional. Transverse myelitis may be diagnosed and treated by the following specialists;
    • A neurologist, who holds expertise in the diagnosis and treatment of diseases of the nervous system, especially those that affect the brain and spinal cord.
    • A neuroimmunologist, who focuses on the relationship between the immune system and the nervous system, and can be involved in the diagnosis and treatment of conditions such as Transverse Myelitis.
    • A physical Medicine and Rehabilitation (PM&R) Specialist, who focuses on the rehabilitation and management of conditions that affect movement and mobility, and can be involved in the management of symptoms associated with Transverse Myelitis.
    • A pain specialist, who specializes in the diagnosis and treatment of pain, and can be involved in managing chronic pain associated with Transverse Myelitis.

    Which are the best medicines for Transverse Myelitis?

    Depending on the patient and the underlying cause of the ailment, different medications will be effective for different cases of transverse myelitis.

    Some commonly used medications for the treatment of Transverse Myelitis include;

    • Corticosteroids: Corticosteroids are powerful anti-inflammatory drugs that can help reduce inflammation in the spinal cord and relieve symptoms.
    • Plasmapheresis: Plasmapheresis is a procedure that removes plasma (the liquid part of the blood) and replaces it with a different fluid to help remove harmful substances from the body.
    • Immunoglobulin Therapy: Immunoglobulin therapy helps to strengthen the immune system by injecting immunoglobulin, a blood protein, into the bloodstream.
    • Antiviral or Antibiotic Medications: If an underlying infection is causing Transverse Myelitis, antiviral or antibiotic medications may be prescribed to help treat the infection and manage symptoms.

    How long does it take to recover from Transverse Myelitis?

    Recovery from Transverse Myelitis can vary greatly depending on the severity of the condition and the individual. Some individuals may recover fully within a few months, while others may experience ongoing symptoms for several years or more.

    Also, early diagnosis and treatment raises the chances of a full recovery for Transverse Myelitis patients. With prompt and appropriate treatment, many individuals are able to return to their normal activities and resume their daily routines. However, the severity and duration of symptoms can vary greatly, and some individuals may experience ongoing symptoms, such as chronic pain or muscle weakness.

    Other therapies, such as physical therapy and rehabilitation, can aid in symptom management and recovery. Many patients with transverse myelitis can fully recover with the right care and therapy.

    Are the results of the treatment permanent?

    The permanence of treatment results for Transverse Myelitis can vary greatly depending on the individual and the underlying cause of the condition. For some people, the results of treatment are permanent and they experience no further symptoms, while others may continue to experience symptoms and require ongoing treatment.

    It is important to understand that every case of Transverse Myelitis is unique, and the outcome of treatment will depend on a variety of factors, including the severity of the condition, the individual's overall health, and the underlying cause. Early diagnosis and prompt treatment can improve the chances of a full recovery and reduce the risk of long-term complications.

    In general, physical therapy, rehabilitation, and other therapies can help manage symptoms and promote recovery. While there is no guarantee that the results of treatment will be permanent, many individuals are able to improve their quality of life with proper treatment and care. It's important to work with a healthcare provider to develop a personalized treatment plan that takes into account the individual's specific needs and goals.

    Who is eligible for the treatment?

    Transverse Myelitis is a condition that affects the spinal cord and can cause a range of symptoms, including pain, weakness, and numbness. In the majority of cases, those who have been given a transverse myelitis diagnosis and are exhibiting symptoms are advised to seek treatment.

    The underlying cause of the ailment, the severity of the symptoms, and the person's general health may all affect eligibility for therapy. Working with a healthcare professional to choose the best course of action for your particular requirements is crucial.

    Who is not eligible for the treatment?

    In some cases, individuals with Transverse Myelitis may not be eligible for treatment, or may not be eligible for certain treatments, due to other medical conditions or contraindications. For instance, people with certain illnesses, such heart disease or blood disorders, could not be eligible for certain treatments or medications. It's crucial to follow the guidelines.

    What are the post-treatment guidelines?

    It is crucial to adhere to the instructions given by your healthcare practitioner to guarantee the best result and avoid any potential issues. Some of the key post-treatment guidelines for Transverse Myelitis include;

    • Follow a healthy diet: A balanced diet rich in nutrients can help support the body during the recovery process. Your healthcare provider can provide guidance on which foods to eat and which to avoid.
    • Stay active:Regular exercise and physical activity can help keep muscles strong and retain mobility. However, it is important to start slowly and only engage in activities that are safe and appropriate for your level of recovery.
    • Avoid straining the affected area: It is important to avoid any activities that put undue strain on the affected area, such as heavy lifting or strenuous physical activity, until the body has fully recovered.
    • Get enough rest: Getting adequate sleep and enough rest helps hasten the body's healing and recovery.
    • Attend follow-up appointments: Regular follow-up appointments with your healthcare provider can help monitor your progress and ensure that any potential complications are addressed promptly.

    By following these post-treatment guidelines, individuals with Transverse Myelitis can improve their chances of a successful recovery and maintain their quality of life.

    What is the price of Transverse Myelitis treatments in India?

    The cost of treatment for Transverse Myelitis in India can vary widely depending on the severity and extent of the condition, as well as the specific treatment method being used. On average, the cost of treatment may range from Rs 500 to Rs 50,000.

    It is important to note that more advanced and specialized treatment methods, such as plasma exchange therapy and stem cell replacement therapy, may incur a greater cost compared to more traditional medications. The exact cost of treatment will depend on a number of factors, including the type of treatment, the location of the medical facility, and the qualifications and experience of the healthcare provider.

    What are side-effects of Transverse Myelitis treatments?

    Though treatment can help manage symptoms and promote recovery, it can also lead to a range of side effects, that may include;

    • Nausea, vomiting, and diarrhea
    • Headaches and dizziness
    • Muscle pain and weakness
    • Fatigue and sleep disturbances
    • Allergic reactions
    • Changes in heart rate or blood pressure
    • Risk of infection
    • Pain or discomfort at the site of injection or procedure

    Understanding the potential side effects of Transverse Myelitis treatments is important for individuals considering its treatment.

    Transverse Myelitis - Outlook / Prognosis

    The prognosis for those who have transverse myelitis can change based on a number of variables, such as the underlying etiology, the seriousness of the symptoms, and how well they respond to treatment. For some individuals, Transverse Myelitis may resolve on its own within a matter of weeks, while others may experience more persistent symptoms that require ongoing management.

    In general, the prognosis for Transverse Myelitis is generally favorable, especially when treatment is started early and the condition is well-managed. With appropriate care, many individuals with Transverse Myelitis are able to recover fully or experience only minor lingering symptoms. In some cases, however, individuals may experience long-term complications or residual symptoms, such as weakness, numbness, or pain.

    Working closely with a healthcare professional will help you choose the best course of action for your unique needs and track your development over time. With the right care and support, many individuals with Transverse Myelitis are able to achieve a positive outcome and live a full and active life.

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    Written ByDr. Chirag Dalal MS - OrthopaedicsOrthopaedics
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