Transverse Myelitis

Abstract

Transverse myelitis (TM) includes a pathobiologically heterogeneous syndrome characterized by acute or subacute spinal cord dysfunction resulting in paresis, a sensory level, and autonomic (bladder, bowel, and sexual) impairment below the level of the lesion. Etiologies for TM can be broadly classified as parainfectious, paraneoplastic, drug/toxin-induced, systemic autoimmune disorders, and acquired demyelinating diseases. We discuss the clinical evaluation, workup, and acute and long-term management of patients with TM. Additionally, we briefly discuss various disease entities that may cause TM and their salient distinguishing features, as well as disorders that may mimic TM.

A rare case of acute transverse myelitis associated with Staphylococcus aureus bacteremia and osteomyelitis

“…The presence of osteomyelitis (confirmed by imaging and biopsy) close to the site of myelitis suggests the possibility of contiguous spread of the infection, although the affected vertebrae (C5-T1) were at a lower level than the level of myelitis (C3-C5). On the other hand, MSSA was not isolated from CSF (both CSF cultures and PCR were negative) or culture of the tissue biopsies (which, however, were taken late in the course of antibiotic treatment), which points to alternative mechanisms (for example, parainfectious immune-mediated myelitis 1,5 ).…”

“…Other causes of myelopathy that may mimic transverse myelitis clinically include compressive myelopathy, vascular diseases (for example, spinal cord infarct), radiation myelitis, trauma and nutritional deficiencies (for example, dorsal column degeneration with B12/vitamin E/copper deficiency). 2,4,5 A long list of pathogens have been reported in association with acute myelitis. 5 Typically, myelitis occurs after the resolution of the initial infection, 5 which suggests an immune-mediated effect.…”

“…2,4,5 A long list of pathogens have been reported in association with acute myelitis. 5 Typically, myelitis occurs after the resolution of the initial infection, 5 which suggests an immune-mediated effect. Direct bacterial myelitis is considered very rare.…”

A case of pediatric paraparesis secondary to an idiopathic acute transverse myelitis

“…Oligoclonal bands should always be sought, because if they are found in the CSF and not in the blood, they raise the risk for multiple sclerosis [9]. An ophthalmologic evaluation is also recommended for all patients, as an additional finding of optic neuritis has a major implication on the diagnosis (multiple sclerosis or optic neuromyelitis) [6,9].…”

“…An ophthalmologic evaluation is also recommended for all patients, as an additional finding of optic neuritis has a major implication on the diagnosis (multiple sclerosis or optic neuromyelitis) [6,9].…”