transverse myelitis

Introduction

transverse myelitis is inflammation of the spinal cord which produces neurological changes often with a transverse band-like sensory deficit.
it may be rapidly developing over hours or days and is then called “acute” or evolve over weeks and then is called “subacute”

immune disorders
- multiple sclerosis (MS) - tends to cause a partial myelitis
- aquaporin-4 autoantibody associated neuromyelitis optica - tends to cause complete myelitis
- post-infectious or post-vaccine autoimmune phenomenon
- abnormal immune response to an underlying cancer
- other antibody-mediated conditions
viral infections
- varicella-zoster virus (chickenpox/shingles)
- Herpes simplex virus (HSV)
- cytomegalovirus (CMV)
- EBV / glandular fever / infectious mononucleosis
- flaviviruses - zika virus, West Nile
- influenza
- echovirus
- hepatitis B virus
- mumps
- measles
- rubella
bacterial infections
- syphilis
- tuberculosis (TB)
- actinomyces
- pertussis (whooping cough)
- diphtheria
- Lyme disease
- bacterial skin or otitis media infections
- Campylobacter
- mycoplasma
fungal infections
- aspergillus, Blastomyces, Coccidioides, and Cryptococcus
parasites
- toxoplasmosis, Cysticercosis, schistosomiasis, and angiostrongyliasis
inflammatory disorders
vascular
- AV malformation
- dural A-V fistula
- intraspinal cavernous malformations
- disk embolism

depends upon the level of the inflammation
weakness of the lower limb(s) / weak in the knees which may progress to paraplegia
pain in lower back, or sciatica like pains radiating down the leg(s)
can cause paraesthesiae which may be worse on neck flexion (Lhermitte’s phenomenon)
can cause bowel or bladder dysfunction
can cause upper limb weakness or paraesthesiae if lesion is higher up in the spinal cord
may have associated symptoms of muscle spasms, discomfort, headache, fever, anorexia, etc