What is transverse myelitis?

Transverse myelitis (TM) is a rare neurological syndrome. It is an inflammatory disorder of the spinal cord. TM may be due to a virus or other infection, but in general, the cause is unknown. TM is an autoimmune disorder, meaning that the immune system attacks the body's own tissues. In general, TM is a one-time disease with a sudden onset followed by improvement or stabilization.

What are the risk factors associated with transverse myelitis?

Transverse myelitis can occur in any population at any age. Certain people with TM have a related disorder, neuromyelitis optica (NMO). NMO is another neurological disorder that is similar to multiple sclerosis that may cause severe symptoms involving the optic nerve and spinal cord. Some people with incomplete TM may develop multiple sclerosis (MS), but most patients with typical TM do not go on to develop MS.

Recently, a team of researchers at Johns Hopkins found that the spinal fluid of patients with TM shows strikingly high levels of an immune protein (Il-6). The researchers think that the high levels of the protein may be a cause of TM, but this theory has not yet been firmly established.

Transverse myelitis may occur with other diseases, and sometimes testing needs to be directed at isolating these disorders as well as the TM.

  • In many cases, the TM is idiopathic, meaning that a specific cause is not identified.
  • In some cases, TM can develop as one type of MS attack, either the first attack or a relapse.
  • In general, TM in MS tends to be a less severe form of TM.
  • Devic's disease (or neuromyelitis optica, NMO) is a disorder related to MS that produces severe recurrent TM and optic neuritis (inflammation in the optic nerve that connects the eye to the brain).
  • TM may occur with systemic inflammatory diseases. Diseases like systemic lupus erythematosus, Sjogren's syndrome, or sarcoidosis can cause TM.
  • TM can develop in association with a variety of infections caused by both viruses (such as herpes simplex, Epstein-Barr, influenza, and HIV) and bacteria (such as tuberculosis, syphilis, and Lyme's disease).

What are the symptoms of transverse myelitis?

People with symptoms of transverse myelitis may:

  • Develop a rapidly progressive disorder with back pain, numbness, and tingling in the legs, trunk, and sometimes arms.
  • Have weakness in the legs and sometimes in the arms. The weakness may become severe at times, leading to complete paralysis.
  • Have trouble with bowel and bladder function.
  • Have fever.