Transverse myelitis

What it is

Transverse myelitis is an immune-mediated disorder that primarily affects the thoracic spinal cord. It is defined as an acute or subacute inflammatory myelopathy that results in motor, sensory, and autonomic symptoms below the level of the affected segment.

How it presents

It leads to lower limb motor weakness, autonomic dysfunction, and sensory dysfunction, and the symptoms may reach their peak between 4 hours and 21 days after onset. Motor dysfunction is paresis or paraplegia; sensory dysfunction is numbness, paresthesia and a circumferential dysesthesia directly above the sensory level; autonomic dysfunction is bladder or bowel incontinence and sexual dysfunction, and early loss of the bladder and bowel continence is named beside them.

Causes and risk

The etiology is most often idiopathic. The other groups are para infectious causes, for example enteroviruses, EBV, CMV, Listeria monocytogenes and B. burgdorferi; CNS demyelinating disorders; systemic inflammatory autoimmune disorders; and paraneoplastic syndromes. Multiple sclerosis may present with transverse myelitis, which is the spinal cord face of that disease as optic neuritis is its eye face.