Transverse myelitis
A guide for patients and carers
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Possible treatments for transverse myelitis
Unfortunately, there is no cure for transverse myelitis.
The most common form of treatment is a short course of corticosteroids to reduce the inflammation and reduce the immune system’s activity in the spinal cord. The length of the treatment depends on your progress but might last several weeks if you are prescribed a corticosteroid drug to be taken by mouth. Alternatively, you might be given a three or five day course of corticosteroids through a drip (into a vein in your arm).
The most common form of treatment is a short course of corticosteroids to reduce the inflammation and reduce the immune system’s activity in the spinal cord. The length of the treatment depends on your progress but might last several weeks if you are prescribed a corticosteroid drug to be taken by mouth. Alternatively, you might be given a three or five day course of corticosteroids through a drip (into a vein in your arm).
If corticosteroids do not work for you, you might be given a treatment called plasma exchange (also known as plasma exchange therapy or plasmapheresis). This treatment is not available in all hospitals and might not be suitable for all patients.
Some of the substances which attack the spinal cord as part of the autoimmune reaction are found in the plasma (a colourless fluid in our blood). The aim of plasma exchange is to remove these substances from the blood.
Plasma exchange involves running the patient’s blood through a machine which separates the blood cells from the plasma. The blood cells are then mixed with replacement plasma and the new blood (consisting of the patient’s own blood cells and the replacement plasma) is returned to the patient. It is likely that the plasma exchange will happen over two or three sessions rather than all at once.
Corticosteroids are also known simply as steroids. They should not be confused with anabolic steroids which can boost muscle strength and whose illegal use is associated with sports people and bodybuilders.
Corticosteroids are commonly given to people to reduce inflammation, suppress the immune system, and replace hormones.
For people with transverse myelitis, corticosteroids are given to reduce the inflammation in the spinal cord and to suppress the immune system which is mistakenly attacking it.
Corticosteroids are usually given in short courses to reduce the risk of unwanted side effects. Your doctor will discuss with you the possible side effects.
The names of the corticosteroids you are likely to be given for transverse myelitis are prednisolone (by mouth) or methylprednisolone (through a drip).
It is common for people with transverse myelitis to experience some form of pain. This can be constant pain, or pain that comes and goes. The pain might be related to physical problems (muscle spasms or strains) or related to damage in the spinal cord. Messages (nerve impulses) might not be able to travel properly in the spinal cord, confusing the brain and causing it to interpret them as pain signals. Various types of pain-relief medication are available for the different forms of pain people might experience. If you are given pain-relief, the particular type will depend on your individual situation.
If you have bladder problems, you might need a catheter inserted into your bladder to prevent it overfilling with urine. This is usually a short-term measure and you will be assessed regularly.
During the acute stage of your symptoms, you might not be able to move from bed and will receive general nursing care. If you are experiencing paralysis, you might be cared for by nurses who specialise in preventing and treating complications specifically associated with paralysis.
If you have physical symptoms such as weakness in your legs, muscle spasms (spasticity), stiffness or paralysis, you are likely to be assessed by a physiotherapist. The physiotherapist will recommend movements and exercises designed to increase muscle strength and flexibility and to reduce stiffness and spasms. You might be transferred to a specialist rehabilitation unit for physiotherapy.
Some of the substances which attack the spinal cord as part of the autoimmune reaction are found in the plasma (a colourless fluid in our blood). The aim of plasma exchange is to remove these substances from the blood.
Plasma exchange involves running the patient’s blood through a machine which separates the blood cells from the plasma. The blood cells are then mixed with replacement plasma and the new blood (consisting of the patient’s own blood cells and the replacement plasma) is returned to the patient. It is likely that the plasma exchange will happen over two or three sessions rather than all at once.
Corticosteroids
Corticosteroids are also known simply as steroids. They should not be confused with anabolic steroids which can boost muscle strength and whose illegal use is associated with sports people and bodybuilders.
Corticosteroids are commonly given to people to reduce inflammation, suppress the immune system, and replace hormones.
For people with transverse myelitis, corticosteroids are given to reduce the inflammation in the spinal cord and to suppress the immune system which is mistakenly attacking it.
Corticosteroids are usually given in short courses to reduce the risk of unwanted side effects. Your doctor will discuss with you the possible side effects.
The names of the corticosteroids you are likely to be given for transverse myelitis are prednisolone (by mouth) or methylprednisolone (through a drip).
Other treatments for transverse myelitis
It is common for people with transverse myelitis to experience some form of pain. This can be constant pain, or pain that comes and goes. The pain might be related to physical problems (muscle spasms or strains) or related to damage in the spinal cord. Messages (nerve impulses) might not be able to travel properly in the spinal cord, confusing the brain and causing it to interpret them as pain signals. Various types of pain-relief medication are available for the different forms of pain people might experience. If you are given pain-relief, the particular type will depend on your individual situation.
If you have bladder problems, you might need a catheter inserted into your bladder to prevent it overfilling with urine. This is usually a short-term measure and you will be assessed regularly.
During the acute stage of your symptoms, you might not be able to move from bed and will receive general nursing care. If you are experiencing paralysis, you might be cared for by nurses who specialise in preventing and treating complications specifically associated with paralysis.
If you have physical symptoms such as weakness in your legs, muscle spasms (spasticity), stiffness or paralysis, you are likely to be assessed by a physiotherapist. The physiotherapist will recommend movements and exercises designed to increase muscle strength and flexibility and to reduce stiffness and spasms. You might be transferred to a specialist rehabilitation unit for physiotherapy.
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Page 6 of 16
Contents
- What is transverse myelitis?
- What causes transverse myelitis?
- How common is transverse myelitis?
- What are the symptoms of transverse myelitis?
- Tests and investigations for transverse myelitis
- Possible treatments for transverse myelitis
- Going home
- Recovery from transverse myelitis
- Longer term effects of transverse myelitis
- Relapses
- Other demyelinating conditions
- Future treatments for transverse myelitis
- Useful contacts
- Support groups and further reading
- Thank you
- Your feedback on Transverse Myelitis
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Transverse myelitis
ISBN 978-1-901893-57-1
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