Types
- Poliomyelitis: viral infection in grey matter with symptoms of muscle paralysis or weakness.
- Leukomyelitis: lesions in the white matter.
- Transverse myelitis: axonal demyelination encompassing both sides of the spinal cord.
- Meningococcal myelitis: lesions in the region of the meninges and the spinal cord
Acute Transverse Myelitis
Inflammation damages nerve fibres causing them to lose their myelin coating, leading to decreased electrical conductivity in the CNS. Transverse implies that the inflammation extends across the width of the spinal cord. The onset is sudden and progresses rapidly in hours and days.
Etiology
- Immune system disorders
- Aquaporin-4 autoantibody associated neuromyelitis optica
- MS
- Post-infectious or post-vaccine autoimmune phenomenon
- Viral infections
- Varicella zoster
- Herpes simplex
- Cytomegalovirus
- Bacterial infections
- Syphilis, tuberculosis
- Fungal and parasitic infections
- Other inflammatory disorders
- Sarcoidosis, SLE, Bechets’ syndrome
Clinical feature
- Weakness of the legs and arms: leg weakness progresses rapidly. If upper spinal cord affected, it may affect arms. May develop paraparesis that may lead to paraplegia
- Pain: Lower back pain or sharp, shooting sensations that radiate down the legs/arms/around the torso
- Sensory alterations: Paresthesias in the legs and sensory loss. Abnormal sensations in the torso and genital region. Lhermitte’s phenomenon: shooting sensations occur when the neck is bent forward and resolve when the neck is brought back to the normal position.
- Bowel and bladder dysfunction: ↑ urination, incontinence, difficulty voiding, constipation