What is Transverse Myelitis?

Transverse myelitis is a neurological condition characterized by inflammation of the spinal cord. It occurs when the immune system mistakenly attacks the spinal cord, damaging the nerve fibers and causing various neurological symptoms.

The inflammation in transverse myelitis disrupts the normal functioning of the spinal cord, affecting the transmission of nerve signals between the brain and the rest of the body. 

The exact cause of transverse myelitis is often unknown, but it is thought to result from an autoimmune response, where the immune system mistakenly attacks the healthy tissue of the spinal cord. It can be associated with viral or bacterial infections, vaccination, or certain autoimmune disorders such as multiple sclerosis.

What Symptoms are Caused by Transverse Myelitis?

Transverse myelitis can cause a variety of symptoms that typically appear suddenly and progress rapidly over a few hours to a few weeks. The specific symptoms experienced may vary from person to person, but commonly observed symptoms include:

Sensory disturbances: Patients may experience abnormal sensations in the affected areas of the body, such as numbness, tingling, or a “pins and needles” sensation. Some individuals may have heightened sensitivity to touch, while others may experience decreased sensation or a loss of sensation.

Motor problems: Weakness or paralysis may occur in the muscles controlled by the affected spinal cord segment. This can lead to difficulty walking, performing fine motor tasks, or maintaining balance and coordination. Some individuals may experience muscle spasms or involuntary muscle contractions.

Bladder and bowel dysfunction: Transverse myelitis can disrupt the normal control of bladder and bowel function. This can manifest as urinary urgency, frequency, incontinence (inability to control urination), or retention (inability to empty the bladder fully). Bowel movements may also be affected, leading to constipation or fecal incontinence.

Pain: Many individuals with transverse myelitis experience severe, localized back pain at the level of the inflammation. The pain may be sharp, stabbing, burning, or aching in nature. It can radiate to the arms, legs, or other parts of the body.

Fatigue: Fatigue is a common symptom experienced by individuals with transverse myelitis. It can be debilitating and may significantly impact daily activities.

Other symptoms: Depending on the extent and location of the inflammation, additional symptoms can arise. These may include changes in temperature sensation, altered sexual function, difficulty breathing or swallowing, and abnormalities in reflexes or muscle tone.

It’s important to note that not all individuals will experience every symptom, and the severity and duration of symptoms can vary. Prompt medical evaluation is crucial if you suspect transverse myelitis, as early intervention and treatment can help manage symptoms and prevent further damage.

How is Transverse Myelitis Diagnosed?

The diagnosis of transverse myelitis typically involves several diagnostic steps. Firstly, the doctor will conduct a medical history review and inquire about the symptoms, their onset, and progression. A comprehensive physical examination will be performed to evaluate neurological function, including sensory, motor, and reflex responses. 

To visualize the spinal cord and confirm the diagnosis, a key diagnostic test is an MRI scan, which can detect inflammation, lesions, or structural abnormalities in the spinal cord. In some cases, a lumbar puncture, or spinal tap, may be performed to collect cerebrospinal fluid (CSF) for analysis, which helps identify markers of inflammation, infection, or underlying causes. 

Blood tests may also be conducted to assess autoimmune markers, infectious agents, or other potential contributors to transverse myelitis. Additional tests, such as electromyography (EMG) and nerve conduction studies, can assess nerve function and muscle activity while ruling out similar conditions. 

Evoked potentials, which measure the electrical responses of the brain and spinal cord to sensory stimuli, are used to evaluate nerve signal conduction and detect abnormalities along the spinal cord. 

These diagnostic steps are vital for accurate diagnosis and appropriate management of transverse myelitis.

How is Transverse Myelitis Treated?

The treatment of transverse myelitis aims to manage symptoms, address the underlying cause (if known), and promote functional recovery. The specific treatment approach may vary depending on the individual’s symptoms, severity of the condition, and the underlying cause. Here are some common treatment options:

High-dose intravenous corticosteroids: Corticosteroids, such as methylprednisolone, are often prescribed as the initial treatment for transverse myelitis. They help reduce inflammation in the spinal cord and may help shorten the duration of symptoms. These medications are usually administered through a vein (intravenously) over a few days.

Plasma exchange (plasmapheresis): Plasma exchange involves removing a portion of the patient’s blood, separating the liquid portion (plasma), and replacing it with donor plasma or a substitute. This procedure aims to remove harmful antibodies or immune system components that may be contributing to the inflammation.

Immune system modulating therapies: In cases where transverse myelitis is associated with an autoimmune condition, additional medications may be prescribed to modify or suppress the immune system’s response. These can include immunosuppressants, such as azathioprine or mycophenolate mofetil, or immune system modulators like intravenous immunoglobulin (IVIG).

Symptomatic treatment: Various medications and therapies can be employed to manage specific symptoms. For example, medications may be prescribed to alleviate pain, muscle spasms, or urinary/bowel dysfunction. Physical and occupational therapy can help improve strength, mobility, and functional abilities. Assistive devices or adaptive equipment may also be recommended to aid in daily activities.

Treatment of underlying cause: If a specific cause or trigger is identified, such as an infection or autoimmune disorder, treating that underlying condition becomes an important part of the overall management.

Supportive care: Transverse myelitis can significantly impact an individual’s quality of life. Supportive care, including psychological support, counseling, and rehabilitation services, can be beneficial in managing the emotional and physical challenges associated with the condition.

It is important to work closely with a healthcare professional experienced in treating neurological disorders to determine the most appropriate treatment plan for transverse myelitis. They can assess individual circumstances and tailor the treatment approach accordingly. Early intervention and prompt treatment can help manage symptoms, minimize complications, and optimize long-term outcomes.

Mesenchymal Stem Cells for Transverse Myelitis

Mesenchymal stem cells (MSCs) have shown promise in the treatment of various neurological conditions, including transverse myelitis. MSCs are multipotent stem cells that can differentiate into different cell types and possess immunomodulatory and regenerative properties. Here’s an overview of the use of MSCs in transverse myelitis:

MSCs have the potential in reducing inflammation, promoting tissue repair, and improving functional recovery in transverse myelitis.

MSCs have immunomodulatory properties, meaning they can modulate the immune response and suppress excessive inflammation. This can help reduce the damage caused by immune system activity in transverse myelitis.

MSCs release anti-inflammatory molecules that can reduce inflammation and protect the spinal cord from further damage. This can potentially alleviate symptoms and promote healing.

MSCs have the ability to differentiate into various cell types, including neuronal cells and supporting cells. When introduced into the injured spinal cord, they can potentially aid in tissue repair and regeneration.

Some clinical trials have explored the safety and efficacy of MSCs in transverse myelitis and other spinal cord disorders. These trials have shown promising results in terms of safety and potential therapeutic benefits, including improved neurological function and quality of life.

If you or someone you know is interested in exploring MSC therapy for transverse myelitis, it’s crucial to consult with a qualified healthcare professional who specializes in stem cell therapy or neurological disorders. They can provide guidance, discuss the potential benefits and risks, and help determine the suitability of MSC therapy on an individual basis.