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Transverse myelitis
A guide for patients and carers
What is transverse myelitis?
Transverse myelitis is a disease of the central nervous system in which there is inflammation over a section of the spinal cord. This inflammation causes swelling which can block messages travelling in the spinal cord. When the swelling goes down, this blocking gradually disappears. The inflammation can also damage the myelin sheaths around nerve axons, probably by damaging myelin-producing oligodendrocytes. When myelin is stripped off the axons by the inflammation, the electrical impulses slow down and the messages are not transmitted properly. Recovery takes longer when the myelin sheath has been damaged.
The inflammation occurs most frequently in the thoracic area, below the upper spinal cord where messages are relayed to and from the arms. It does not usually involve inflammation in other areas of the central nervous system (CNS). In about one quarter of patients, the inflammation is higher in the spinal cord and the arms are affected to some extent.
Transverse myelitis most commonly begins suddenly over a day or two and can reach its maximum effect very quickly. However, for some people, the symptoms develop over a number of weeks. The symptoms and the severity of the disease depend on how intense the inflammation is. For most people there will be a combination of leg weakness and changed sensation. Some peoplehave back pain or ache though this is not usually severe. The change in feeling may include numbness, “pins and needles” and a loss of the ability to tell the temperature of objects or water. It is easily separated from areas of normal feeling, sometimes to such an extent that a perfectly horizontal line can be drawn on the front and back of the trunk (like a belt) where normal and abnormal sensations meet. This place where normal and abnormal sensations meet can be high up on the chest or around the waist depending on where in the spinal cord the area of inflammation is. There may be a loss of bladder sensation and sometimes sexual function is also affected.
Transverse myelitis most commonly begins suddenly over a day or two and can reach its maximum effect very quickly. However, for some people, the symptoms develop over a number of weeks. The symptoms and the severity of the disease depend on how intense the inflammation is. For most people there will be a combination of leg weakness and changed sensation. Some peoplehave back pain or ache though this is not usually severe. The change in feeling may include numbness, “pins and needles” and a loss of the ability to tell the temperature of objects or water. It is easily separated from areas of normal feeling, sometimes to such an extent that a perfectly horizontal line can be drawn on the front and back of the trunk (like a belt) where normal and abnormal sensations meet. This place where normal and abnormal sensations meet can be high up on the chest or around the waist depending on where in the spinal cord the area of inflammation is. There may be a loss of bladder sensation and sometimes sexual function is also affected.
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