What consequences can acute transverse myelitis have?

Acute myelitis is an inflammatory process that occurs in the brain cells located in the ridge. The name of the pathology comes from the Greek word, translated meaning “spinal cord”. The severity of symptoms directly depends on the degree of spread and the age of the patient. Depending on its location, the disease often causes a disruption in the connection between the brain and the body, dysfunction of internal organs and other severe pathologies. Therefore, early diagnosis is essential to increase the chances of successful treatment.

Etiology

In some cases, the cause of myelitis cannot be identified. However, the disease has a classification based on etiological data:

• Infectious – occurs in 50% of cases. There are primary and secondary flow options. In the first case, the pathology predominantly occurs against the background of HIV infection, syphilis, CMV, enteroviruses, and herpes simplex. The main cause of secondary myelitis is osteomyelitis of the spinal column.
• Intoxication – inflammation develops during poisoning with poisons (acute intoxication with certain medications and psychotropics or prolonged exposure to harmful substances on the body, most often affecting patients with unfavorable working conditions).
• Traumatic - in case of spinal injuries, the main cause of the development of inflammatory processes is damage to the spinal column and disruption of its functions or the penetration of infection through an open wound surface.

Other causes include autoimmune pathologies affecting the myelin sheath of nerve fibers and immunopathological inflammation of the vascular walls. Sometimes myelitis occurs as a result of metastasis during cancer processes.

Pathogenesis

The development of the disease begins with swelling of the spinal cord, which leads to circulatory disorders and blood clots. The processes contribute to the occurrence of even greater swelling. Thus a vicious circle arises.

Subsequently, poor blood circulation in some areas of the spinal cord stops altogether, causing necrotic processes and softening of tissue structures. Subsequently, during the recovery period, a scar forms in place of the dead tissue and these areas of the organ are not able to perform their previous functions. Therefore, some symptoms that occur during illness may persist for the rest of your life.

general description

Lumbar myelitis (G04) is an acute inflammatory process involving spinal cord structures, characterized by damage to the white and gray matter of the spinal cord.

Prevalence: 1 per 100 thousand people.

The etiology of myelitis includes infectious, toxic, and traumatic factors.

Clinical picture

Symptoms of myelitis and their severity directly depend on the location of the inflammatory processes. As a rule, the thoracic, upper cervical and lumbar regions are affected.

Myelitis is characterized by damage to both individual segments and entire sections of the spinal column, as a result of which the functioning of all conduction systems is disrupted (loss of motor functions and sensitivity).

The onset of the disease is acute - febrile temperature, chills and weakness in the body. The first signs are characteristic of most infectious diseases. Specific symptoms appear after a few days. Initially, a pain syndrome of varying intensity develops in the back area, radiating to the perineum and lower extremities. As a rule, the increase in symptoms takes several hours or days.

Symptoms of damage to the upper segment of the spinal cord appear as follows:

• spastic tetraparesis develops (decreased motor activity in the upper and lower extremities);
• respiratory failure, respiratory arrest (with damage to the cervical nerve plexus);
• persistent motor function disorders;
• Dysfunction of the pelvic organs by type of delay.

Inflammatory processes localized in the thoracic region cause symptoms such as:

• spastic paralysis;
• increased muscle tone in the legs;
• dysfunction of the pelvic organs by type of delay;
• the rapid development of myelitis initially leads to a decrease in muscle tone, and only after some time it causes signs of spasticity and impaired motor activity.

When the lumbosacral region is affected, the following occurs:

• paresis of the lower extremities;
• involuntary urination;
• fecal incontinence;
• atrophy of muscles innervated by damaged nerves occurs.

A common symptom for damage to any segment of the spinal cord is sensitivity disorder. Impaired sensitivity is always noted below the affected area and is manifested by a decrease or absence of pain, a decrease in the reaction to heat and cold, and touch.

Diagnostic procedures

Having understood the question of what myelitis is, you should understand how it is detected. The initial examination and patient complaints are usually not enough to make a diagnosis, so specialists almost always prescribe laboratory and hardware tests. Diagnostics consists of the following stages:

• Neurological examination. During the process, the doctor carefully examines the patient, conducts a series of simple tests to determine violations of the body’s natural reactions and reflexes, loss of sensitivity and muscle tone.
• Blood and urine tests. The results obtained show ESR and leukocyte levels, which indicate the extent of inflammation, the presence of antibodies and other data.
• Electroneuromyography. With its help, the conductivity of nerve impulses, the degree of disturbance and the location of the lesion are determined.
• MRI. One of the most informative research methods, which allows you to obtain images of the spinal cord in layers. The results help determine the boundaries of the infectious focus and choose the most effective treatment tactics.

MRI is often replaced by CT, which does not affect the quality of the study. Additionally, some patients are prescribed the use of contrast to increase the accuracy of the procedure. And it is also important to carry out tests to identify the pathogen if the cause of the lesion is infectious or viral. After its determination, the general antibiotic is changed to a highly specialized one that suppresses the growth and reproduction of specific pathogenic microflora.

MRI is the most informative way to determine the cause and extent of the lesion

In the process of making a diagnosis, it is extremely important not to confuse myelitis with epiduritis, which requires immediate surgical intervention. Their clinical pictures are very similar, but in addition to general tests, an additional explorative laminectomy will also be required. Affected tissues are examined for the presence of radicular disease or a purulent focus, which distinguishes the disease from myelitis. And also during the examination, a spinal cord tumor or acute kidney injury, hematomyelia, hematorahis are excluded, especially if the cause is trauma.

Treatment of myelitis in Samara

Treatment in the acute phase of the disease is carried out in a hospital neurological department. A treatment regimen for myelitis is developed by a neurologist, taking into account the etiological data and individual characteristics of the development of the disease in a particular patient.

The basis of therapy is broad-spectrum antibacterial agents in large dosages, glucocorticosteroids, and analgesics. In some cases, medications are used to reduce the tone of skeletal muscles, uroseptics (antiseptic drugs to kill infections in the genitourinary organs). For problems with urination, catheterization of the bladder is indicated.

During the rehabilitation period, exercise therapy, therapeutic massage and physiotherapeutic treatment are prescribed. In the First Neurology clinic, the following methods are used in the treatment of myelitis:

• Peripheral magnetic stimulation,
• High top on the affected limbs,
• Injection of botulinum toxin type A into tense muscles,
• Magnetotherapy using the Multimag device,
• Injectable forms of medications and ILBI are prescribed.
• Ozonation of blood.

The goal of therapy is to restore damaged nerve fibers, which will lead to improved motor activity, reduced pain, and restoration of pelvic organ function.

Rehabilitation period

Restoration of damage and normal well-being occurs after relief of the acute stage, the most dangerous of all. To do this, the doctor prescribes the following courses:

• Massage. It perfectly helps to avoid the formation of bedsores on the body and gradually restore sensitivity to the lower extremities. It is carried out by medical specialists, since any incorrect actions or excessive pressure are dangerous for the patient.
• Physiotherapy. At first, it is carried out with medical personnel and for this the patient does not even need to leave the bed. The classes are very simple and are aimed at eliminating stagnant processes, gradually returning to physical activity, improving blood circulation in all tissues, and normalizing metabolism.
• Acupuncture. Impact on certain active points can affect the general condition, reduce pain and swelling, relieve inflammation, and get rid of dysfunction of the pelvic organs. As in other cases, only experienced specialists with a high level of qualifications are allowed to conduct sessions to obtain the desired result.
• Catheterization of the bladder or epicystostomy.

Myelitis is diagnosed in both men and women, but in the fair sex it appears more often due to more unstable hormonal levels and constant exposure to stress. The treatment complex is compiled for each patient individually based on the cause and extent of the lesion.

Our specialists

• Tarasova Svetlana Vitalievna

  Expert No. 1 in the treatment of headaches and migraines. Head of the Center for the Treatment of Pain and Multiple Sclerosis.

  Somnologist.
  Epileptologist. Botulinum therapist. The doctor is a neurologist of the highest category. Physiotherapist. Doctor of Medical Sciences.
  Experience: 23 years.

• Derevianko Leonid Sergeevich

  Head of the Center for Diagnostics and Treatment of Sleep Disorders.

  The doctor is a neurologist of the highest category. Vertebrologist. Somnologist. Epileptologist. Botulinum therapist. Physiotherapist. Experience: 23 years.

• Bezgina Elena Vladimirovna

  The doctor is a neurologist of the highest category. Botulinum therapist. Physiotherapist. Experience: 24 years.

• Volkova Svetlana Anatolevna

  Head of the Center for Parkinsonism and Extrapyramidal Diseases.

  The doctor is a neurologist of the highest category. Epileptologist. Ozone therapist. Physiotherapist. Experience: 26 years.

• Dolgikh Tatyana Anatolevna

  The doctor is a neurologist of the highest qualification category. Experience: 24 years.

• Zhuravleva Nadezhda Vladimirovna

  Head of the center for diagnosis and treatment of myasthenia gravis.

  Read also:  Impulses, synapses and neural networks | Part 1

  The doctor is a neurologist of the highest category. Physiotherapist. Experience: 16 years.

Links[edit]

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