Demystifying the Causes and Management of Transverse Myelitis

If you or someone close to you is living with transverse myelitis, then you know how life-altering this neurological condition can be.  It often results in sudden symptoms, such as muscle weakness, pain and bladder dysfunction.  It has several possible causes. Some people recover from the symptoms and resulting complications of transverse myelitis, while others don’t. 

With its sudden onset and potential for long-term impact, it's important that we have the best understanding of what causes transverse myelitis and what steps, if any, can be taken to minimise the chance of another episode occurring. 

In this blog post, we'll take a closer look at the underlying causes, transverse myelitis symptoms, as well as potential ways to reduce it's severity and increase quality of life through some of the technology we offer.

Understanding Transverse Myelitis: Causes and Effects

Transverse myelitis is one of those rare neurological disorders seen in physical medicine that affects the spinal cord nerve cells. It doesn’t appear to run in families.

It can potentially occur in any person at any age. But it seems to more frequently affect people between the ages of 10 to 19 years, and between 30 to 39 years. Approximately 25% of the cases affect children.  As a rough indication it effects between 1 and 8 persons per million of population.

It occurs when inflammation spreads across a section of the spinal cord nerves, causing damage to the myelin sheath that protects the nerve fibers. This results in a range of neurological symptoms depending on where the spinal cord is affected. Symptoms include weakness or even paralysis in the limbs, numbness or tingling, and bladder or bowel dysfunction. This condition can happen around your spinal cord in any region along your spine.

The causes of transverse myelitis are not fully understood, but it is believed to be an autoimmune disease that occurs when the body's immune system attacks the spinal cord. 

An autoimmune disease is a condition in which the immune system mistakenly attacks and damages the body's own cells, tissues, and organs. In the case of transverse myelitis, the immune system specifically attacks the spinal cord, causing inflammation and damage to the nerve fibers that transmit signals between the brain and the rest of the body.

Although anyone can develop transverse myelitis, certain risk factors, such as a history of viral infection or autoimmune disease, may increase the likelihood of developing this condition. Proper diagnosis and treatment by a medical professional are essential for managing this disease effectively.

Transverse Myelitis Diagnosis and Common Tests

Diagnosing this condition can be a challenging task for doctors, as symptoms vary widely from patient to patient and, as it is one of those rare disorders, there is a risk of delayed diagnosis. It may indeed be described as idiopathic transverse myelitis due it arising from an unknown cause.

To evaluate a patient suspected of having transverse myelitis, doctors often use a range of tests, including magnetic resonance imaging (MRI) scans and a lumbar puncture. 

An MRI scan is used to create detailed images of the spinal cord and brain, allowing doctors to identify any abnormalities. A lumbar puncture involves inserting a needle into the patient’s lower back to obtain a sample of cerebrospinal fluid, which can be tested for signs of inflammation or bacterial infection. While diagnosing transverse myelitis can be complicated, with the right tests and medical expertise, doctors can act to provide a patient with accurate and effective treatment plans.

Related conditions

Diagnosis is really important as there are a range of related conditions where the body's immune system mistakenly attacks the protective layer around nerves in the central nervous system (CNS), which includes the brain, spinal cord, and optic nerves. 

This attack causes damage to the nerves, making it difficult for them to send signals properly. There are several types of these disorders, such as Neuromyelitis Optica Spectrum Disorder(NMO  - sometimes known as Devics Disease), Acute Disseminated Encephalomyelitis (ADEM),  Optic Neuritis (ON), Multiple Sclerosis (MS), Longitudinally Extensive Transverse Myelitis (LETM) and acute transverse myelitis. Researchers are still learning about them and how best to categorise them.

What sets these so-called “neuroimmunologic” disorders apart from each other is where in the nervous system the inflammation occurs, which organs are affected, and whether the problem happens again. 

It's important to note that these disorders can be complex and might change over time. For this reason, the diagnosis may not always be clear-cut because these disorders fall along a spectrum.

Managing Transverse Myelitis: Treatment Options

As we mentioned above, transverse myelitis is thankfully a rare disorder that affects the spinal cord, causing a range of symptoms, inflammation and damage to the nerve fibers. 

The goals of treatment for transverse myelitis will include:

  • Treating the cause, such as an infection, if one can be identified.

  • Reducing inflammation of the spinal cord as quickly as possible.

  • Relieving or reducing symptoms, such as pain.

  • Managing long-term complications.

Treatment always involves acute (short-term) treatment of the inflammation and its cause and long-term management of the complications.

Several treatments are available to help manage this condition. Medications such as steroids and immunosuppressants are often prescribed to reduce inflammation and alleviate symptoms. 

Physical therapy and occupational therapy can help improve mobility and strength, while lifestyle modifications such as adapting the home or workplace to be more accessible can also be beneficial. While transverse myelitis can be a challenging condition to manage, a combination of different treatment options can improve quality of life and help individuals with the condition to maintain independence.

Further details can be found from a reliable source such as the Cleveland Clinic or Mayo Clinic (see References)

Coping with chronic pain and emotional distress in transverse myelitis

Living with transverse myelitis can be challenging, both physically and emotionally. Chronic pain and emotional distress are common symptoms experienced by those with this condition. However, there are various coping strategies that can be adopted to help manage these difficult symptoms. 

One effective approach is cognitive-behavioral therapy, which involves changing negative thought patterns related to pain or distress. Meditation and other relaxation techniques can also be helpful in reducing stress and pain. 

Exercise, physical therapy and assistive technology can improve mobility and strength, while support groups provide a safe space to connect with others who understand what it’s like to live with chronic illness. By utilising these coping strategies, individuals with transverse myelitis can improve their overall quality of life and find relief from their symptoms.

Support Networks 

A number of organisations provide support and resources to people living with Transverse Myelitis. In the UK we have the TM Society for example. (https://www.myelitis.org.uk/)

Having a strong support network can make a huge difference. Thankfully, there are a number of organisations that specialize in providing resources and assistance to those affected by the condition. These groups can offer anything from emotional support to practical help with daily tasks. Being a part of such a network can help individuals feel less isolated and enable them to connect with others who truly understand what they're going through. If you're living with transverse myelitis, know that you're not alone and that there are people and organizations out there that can help.

Research Updates - 

In this section we look at new treatments under investigation or advances in our understanding of Transverse Myelitis

Despite being a mysterious disease, researchers have been working tirelessly to come up with effective treatments to help alleviate the debilitating symptoms of this condition. Recent updates on new treatments under investigation and advances in our understanding of Transverse Myelitis offer a ray of hope for patients and their families. With the development of cutting-edge technology and the latest scientific advancements, we are now closer than ever to unlocking the secrets of this disease and eventually finding a cure. Though there is still much work to be done, the future looks bright for those who suffer from this life-altering condition.

Assistive Technology

 Assistive technology for transverse myelitis patients is essential for enabling them to maintain independence and quality of life. We have seen that this neurological disorder can cause considerable disability; it can result in pain, muscle weakness, bladder dysfunction, and sexual dysfunction. It can also cause functional mobility issues, lower extremity weakness, and vision impairment. Some patients experience transverse myelitis attacks and degrading eyesight, depending on the severity of the condition.

Fortunately, assistive technology for transverse myelitis is improving rapidly, and patients can benefit from a range of assistive devices that make daily activities more comfortable and manageable. 

Some assistive technologies for transverse myelitis patients include electrical stimulation devices that help to reduce muscle spasticity, as well as bladder management tools, to ensure that patients do not experience unwanted urinary urgency or incontinence. 

Physical therapy and occupational therapy can also help to improve patients' physical function and mobility, while cognitive therapy can help individuals to manage symptoms such as cognitive disabilities. These techniques focus on restoring coordination, strength, and function to the affected muscles, nerves, and nerve fibers in the spinal cord.

Anatomical Concepts products relevant to Transverse Myelitis

A number of Anatomical Concept’s products are relevant to Transverse Myelitis. These include

Functional Electrical Stimulation (FES) Cycling with a RehaMove system can be a helpful therapy for some individuals with transverse myelitis. FES Cycling involves the use of low-level electrical currents to stimulate the nerves and muscles in the legs or arms while the person is pedaling a stationary bike. This can help maintain or improve muscle strength, promote blood circulation, and potentially reduce muscle atrophy due to inactivity.

FES Cycling may offer several benefits including:

  1. Improved muscle strength: Regularly stimulating the muscles can help maintain or improve muscle strength, which may contribute to better overall function and mobility.

  2. Better circulation: FES Cycling can promote blood flow to the muscles, which may aid in the delivery of nutrients and oxygen and help remove waste products.

  3. Reduced muscle atrophy: By engaging the muscles, FES Cycling may help reduce the loss of muscle mass often associated with inactivity or paralysis.

  4. Improved overall fitness: Engaging in regular physical activity can have positive effects on cardiovascular health and overall well-being.

RISE Stimulator

Some denervation can occur with transverse myelitis depending on the location of the inflamation. Denervation refers to the loss of nerve supply to a muscle, organ, or other body part. In the case of transverse myelitis, inflammation and damage to the spinal cord can disrupt the normal functioning of nerve pathways, leading to a loss of communication between the nerves and the muscles or organs they control. Denervated muscle will not respond to the type of electricity used in FES Cycling. In these cases we can use the Stimulator RISE or the Edition 5 units (which also has many protocols for working with types of pain).

When weakness affects the muscles of the arm and hand it may be difficult to hold onto objects of form a firm grip. In these cases, the new Carbonhand can help. This is a soft robotic glove system that can help many people with hand grip issues.

The TEK RMD can hep users overcome leg weakness or paralysis

Finally the Tek RMD combines two things that are essential aspects of everyday life - the ability to stand and the ability to move around. The Tek RMD allows users to stand and move around despite leg weakness or paralysis.

Conclusion

In conclusion, we have explored transverse myelitis in depth. We discussed what it is, the risk factors associated with it, how it is diagnosed, and treatments available to address the symptoms associated with this condition.

We also explored how to cope when living with transverse myelitis, along with support networks that are available to help those impacted by this disorder. Finally, we looked at some of assistive technology available from Anatomical Concepts that might help.

Although transverse myelitis can be a daunting diagnosis, by understanding more about it and utilising available resources and treatments, sufferers of this disorder can begin taking steps towards better managing their condition and finding physical and emotional comfort from their symptoms.

References

Cleveland Clinic - (https://my.clevelandclinic.org/health/diseases/8980-transverse-myelitis#management-and-treatment)

Mayo Clinic - (https://www.mayoclinic.org/diseases-conditions/transverse-myelitis/symptoms-causes/syc-20354726)




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Denervated muscle rehabilitation with the RISE Stimulator

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Carbonhand: Getting a better grip and revolutionising hand function