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transverse myelitis

ms pictTransverse myelitis occurs when the immune system attacks a section of the spinal cord. Damage to the spinal cord is known as a myelopathy. The hallmark of a myelopathy is a sensory level. This means that there is a location on the patient below which the patient feels numb and above which sensation is normal. Sometimes this is only on one side of the body. It is also common to have weakness in the parts of the body below the level and normal strength above. In some cases of myelopathy, there are problems with controlling ones bowels and bladder.

There is a large differential for myelopathy and typically a MRI will sort out most of the causes. Once it is identified to be a transverse myelitis, then one has to determine if it is part of multiple sclerosis, neuromyelitis optica, idiopathic (meaning all by itself) or as a consequence of a systemic disease such as lupus. If the patient has sufficient symptoms to warrant therapy, high dose of IV steroids are typically given. If the transverse myelitis appears to be the first attack of multiple sclerosis, than standard multiple sclerosis disease modifying medications are started. If the transverse myelitis is over multiple spinal cord segments, than one needs to consider the diagnosis of neuromyelitis optica.

The multiple sclerosis society supports patients with transverse myelitis in the same manner that they support other MS patients.