Transverse myelitis

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Transverse myelitis (in Latin nomenclature: myelitis transversa) is a neurological disorder caused by an inflammatory process of the spinal cord, and can cause axonal demyelination. The name is derived from Greek myel├│n referring to the "spinal cord", and the suffix -itis, which denotes inflammation.[1] Transverse implies that the inflammation is across the thickness of the spinal cord.

Contents

Presentation

This demyelination arises idiopathically following infections or vaccination, or due to multiple sclerosis. One major theory posits that immune-mediated inflammation is present as the result of exposure to a viral antigen.

The lesions are inflammatory, and involve the spinal cord typically on both sides. With acute transverse myelitis, the onset is sudden and progresses rapidly in hours and days. The lesions can be present anywhere in the spinal cord, though it is usually restricted to only a small portion.

Causes

In some cases, the disease is presumed to be caused by viral infections such as cytomegalovirus (CMV) and has also been associated with spinal cord injuries, immune reactions, schistosomiasis and insufficient blood flow through spinal cord vessels. Acute myelitis accounts for 4 to 5 percent of all cases of neuroborreliosis.[2]

A major differentiation or distinction to be made is a similar condition due to compression of the spinal cord in the spinal canal, due to disease of the surrounding vertebral column. An urgent MRI is thus indicated.

Another possible cause is dissection of the Aorta, extending into one or more of the spinal arteries.

TM can be a rare complication following cat scratch disease.[3]

Prognosis

Recovery from transverse myelitis usually begins between weeks 2 and 12 following onset and may continue for up to 2 years in some patients. Some patients may never show signs of recovery.[4] However, if treated early, some patients experience complete or near complete recovery.

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