MYELOPATHY-TRANSVERSE MYELITIS

SUMMARY

1. TM is a rare problem causing inflammation of both sides of 1 or 2 segments of the cord (usually thoracic).

2. The exact cause is uncertain, but it appears to be an autoimmune reaction.

3. Onset typically follows a viral infection, but it is also associated with MS & several autoimmune disorders.

4. Clinical presentation is most often acute and progressive over a few days, with early paresthesias, bilateral leg weakness, and numbness with a sensory deficit below the level of the lesion, sphincteric disturbances and backache.

5. A slight asymmetry of the symptoms and signs, a sensory level over the trunk, or a Babinski sign differentiate it from a rapidly progressive polyneuropathy such as GBS.

6. MRI with contrast shows the inflammation of the cord. CSF analysis shows increased protein, lymphocytosis, normal glucose.

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].