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Transverse Myelitis

Overview

Transverse myelitis is a neurological disorder that causes inflammation of the spinal cord, affecting one or both sides. The condition damages the myelin, a protective covering on nerve cells. This disrupts the messages spinal cord nerves send to the rest of the body and can lead to a wide range of symptoms affecting nearly every part of the body.

  • Symptoms

    • Back pain
    • Fever
    • Loss of bladder or bowel control
    • Muscle spasms
    • Numbness or tingling in the legs and sometimes the arms
    • Sensitivity to light or to heat/cold
    • Sharp pain shooting down the legs or arms
    • Weakness in the legs and sometimes the arms
  • Prevention

    • No way to prevent transverse myelitis is known.
    • Because the condition often develops following an acute infection, take steps to prevent bacterial and viral illnesses by disinfecting commonly touched surfaces, washing your hands regularly and not touching your face with unwashed hands.
  • Risk Factors

    • Bacterial infections
    • Exposure to parasites
    • Fungal infections affecting the spinal cord
    • Immune system disorders, including multiple sclerosis
    • Viral infections, such as herpes and Epstein-Barr
  • Diagnosis

    Diagnosis

    Medical history and symptom review. A medical provider will carefully review your personal and family medical history, lifestyle habits, and symptoms. Because transverse myelitis often follows an infection, your provider will ask specific questions related to your overall health and any recent illnesses.

    Physical examination. Following a discussion about your health, your medical provider will perform a comprehensive examination, paying particular attention to the areas affected by your reported symptoms. This will likely include a neurological examination.

    Additional tests. Your provider will likely order additional testing to rule out other potential causes of your symptoms and to confirm a transverse myelitis diagnosis. This may include an MRI to look for spinal cord compression, a spinal tap to analyze a sample of spinal fluid and blood tests to rule out other infections and disorders.

  • Treatment

    Treatment for transverse myelitis is designed to address the underlying infection that caused the disorder, reduce inflammation around the spinal cord and alleviate individual symptoms.

    • Corticosteroids are administered intravenously to decrease swelling and inflammation around the spinal cord. After an IV regimen, your provider may also recommend a short course of oral steroids to taper you off the medication.
    • In cases where corticosteroids are ineffective or not tolerated well, a medical provider may recommend plasmapheresis, a plasma exchange therapy. During this procedure, blood cells are removed from the body, and the plasma is removed from them and replaced with another substitute. Blood is then returned to the body. This reduces immune system activity and the resulting inflammation.
    • Immunoglobulin may also be administered intravenously to reset the immune system. • Medications to treat pain or other specific symptoms, such as incontinence or muscle spasms, may also be prescribed.
  • Follow-up Care

    • In the majority of cases, transverse myelitis is considered monophasic, meaning it only occurs once. In that event, your provider will recommend a care plan, which will include how quickly you can begin normal activities and when you should seek follow-up care.
    • Patients who experience chronic transverse myelitis may need additional and ongoing care to lessen the likelihood of future flare-ups. This may include treatment of underlying medical disorders, such as multiple sclerosis.
    • For those who experience loss of function after transverse myelitis, a medical provider may recommend physical or occupational therapies to help regain abilities and maintain quality of life. Assistive devices and equipment may also be needed to help overcome temporary or permanent disabilities.