Transverse myelitis is a condition which is caused by inflammation of the entire width of the spinal cord which damages nerve fibers. The damage brings a reduction in myelin levels which then reduces electrical conductivity between the brain and spinal cоrd.
There is no apparent predisposition for transverse myelitis – anyone can have it – children and adults, males and females and estimates say that about 33,000 people in the USA have some sort of disability which has been caused by transverse myelitis.
Transverse myelitis symptoms
It usually starts with lower back pain, unusual feeling in feet or weakness in muscles. However, it often progresses rapidly, leading to serious problems such as loss of control over bowels, urinary retention and even paralysis. The results can range from complete recovery, following treatment, but also to permanent damage which can make even the simplest daily tasks impossible.
Symptoms can also vary greatly depending on which part of the spinal cord is affected. If the neck part of the spinal cord is affected, it can bring problems to arms and legs. Also, inflammation in the same part of the spinal cord can lead to respiratory failure due to issues with abdominal diaphragm. About 1/5 of patients suffering from transverse myelitis have problems with the neck part.
When the upper back region of the spinal cord is affected, patients can experience problems such as spastic diplegia, which manifests itself as stiffness in the legs and pelvis muscles and is actually a form of cerebral palsy.
Lumbar part also affects hips and legs, while sacral nerves move on to toes and groin, while also affecting some parts of legs.
The most common signs of transverse myelitis include back pain, reduction in motor skills and changes in sensation, problems with sphincter control and autonomic nervous system (which leads to bladder, bowel and blood pressure problems), as well as weakness in the muscles of the limbs.
Transverse myelitis causes
The inflammation that leads to transverse myelitis can come from many sources, including injuries to the spinal cord, various immune system responses, reduced blood flow through the blood vessels in the spinal cord, snail fever caused by a parasitic worm, lesions which cause multiple sclerosis, some viral infections, mycoplasma pneumonia, Bartonella henselae, herpes simplex and zoster, Lyme disease, varicella zoster, cytomegalovirus, flu, echovirus, rubella, hepatitis A, vascular etiology and more.
Acute transverse myelitis is notorious for being rapidly progressive. Its initial symptoms appear suddenly and they progress within a few days or, in very severe cases, in a few hours.
Patients who are diagnosed with transverse myelitis must visit neurologist or neurosurgeon. In many cases they cannot travel on their own and need to be transferred. When this happens, it is very important to make sure that there are respiratory assistance options available in case there are breathing issues. Catheter is also necessary if bladder dysfunction occurs.
Transverse myelitis prognosis
About 1/3 of patients reach full recovery, 1/3 significant recovery but with remaining issues and 1/3 no recovery.
Transverse myelitis treatments
Having in mind that inflammation is the main cause, anti-inflammatory drugs are a must. They should help relieve inflammation and also manage pain. However, the treatment also greatly depends on the underlying cause. Diagnosing transverse myelitis early greatly increases the possibility of full recovery.
Also, there are treatment options such as aggressive physical therapy and supervised recovery. They often yield some improvement.
Once the treatment has started, the patient’s initial response is very indicative of the expected results. If there is significant improvement within the first six months, patients can expect noticeable or complete recovery. If after six months there is no significant improvement, it is not very likely that full recovery will ever occur.
Sadly, most treatment options are aimed at relieving inflammation and dealing with symptoms. Inflammation is most often treated using corticosteroid therapy, which comes with side effects. Moreover, not all patients react well to such treatment. Painkillers are also used to treat pain.
Another treatment option has been experiencing increased dedication recently. It is palmitoylethanolamide (PEA), an anti-inflammatory and pain relieving medical food which has only one ingredient – palmitoylethanolamide. It is an endogenous substance used to relieve inflammation and bring cells back to their natural healthy state. Aside from the anti-inflammatory and pain relieving properties, PEA also has two more advantages over regular painkillers and corticosteroids.
First of all, it is completely devoid of side effects. It is completely safe for anyone. There is no possibility of overdose and no habituation. The latter means that, unlike most painkillers, prolonged usage of PEA will not bring a reduction in efficacy due to the fact that our bodies become accustomed to the substance. Quite the opposite, the prolonged usage will increase efficacy, since more PEA will be present in the body.
Secondly, PEA works well with any other medicine. There are no negative interactions. This is a major advantage, since PEA does take some time to build up inside the body. This buildup period lasts between a few days and about three months, which means that other anti-inflammatory and painkilling options are necessary. However, the mentioned lack of negative interactions between PEA and other medicines means that you can take them together until the levels of PEA build up inside the body and take over the battle against inflammation.