Transverse Myelitis

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Transverse Myelitis

Question:

My uncle was diagnosed with transverse myelitis. His symptoms are relatively mild. He has back pain and weakness in the legs. Can you tell me more about the causes, symptoms and treatment of this condition? Am I at risk for getting it?

Answer:

Transverse myelitis is a rare condition in which there is inflammation in a portion of the spinal cord. Symptoms depend on which part of the spinal cord is affected.

If the inflammation is in the upper portion of the spine (the cervical cord), symptoms may include sudden pain, and numbness and weakness in the arms and legs. If the inflammation is in the lower part of the spinal cord, leg weakness may be the main symptom. Sometimes, transverse myelitis may cause bowel or bladder incontinence.

In most cases, transverse myelitis has no identifiable cause. Occasionally, it's associated with other diseases, including:

• Multiple sclerosis

• Systemic lupus erythematosus (lupus) or other autoimmune disorders

• Antiphospholipid antibody syndrome, a condition in which the blood has an abnormal tendency to clot

The diagnosis is usually established by magnetic resonance imaging (MRI). Treatment may include corticosteroids. Other immunosuppressive drugs may be recommended, especially if there is an underlying disease such as multiple sclerosis or lupus. Blood thinners could be helpful if the underlying cause is antiphospholipid antibody syndrome.

Although multiple sclerosis and other autoimmune diseases sometimes run in families, transverse myelitis does not. So I don't think your uncle's medical history puts you at increased risk for developing this rare neurological problem.

Robert Shmerling, M.D., is associate physician and clinical chief of rheumatology at Beth Israel Deaconess Medical Center and an associate professor in medicine at Harvard Medical School. He is an active teacher in the Internal Medicine Residency Program, serving as the Robinson Firm Chief. He is also a teacher in the Rheumatology Fellowship Program and has been a practicing rheumatologist for over 25 years.

Last updated:	July 20, 2009