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Disease Profile
Transverse myelitis
Prevalence estimates on Rare Medical Network websites are calculated based on data available from numerous sources, including US and European government statistics, the NIH, Orphanet, and published epidemiologic studies. Rare disease population data is recognized to be highly variable, and based on a wide variety of source data and methodologies, so the prevalence data on this site should be assumed to be estimated and cannot be considered to be absolutely correct.
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Age of onset
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ICD-10
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Inheritance
Autosomal dominant A pathogenic variant in only one gene copy in each cell is sufficient to cause an autosomal dominant disease.
Autosomal recessive Pathogenic variants in both copies of each gene of the chromosome are needed to cause an autosomal recessive disease and observe the mutant phenotype.
X-linked
dominant X-linked dominant inheritance, sometimes referred to as X-linked dominance, is a mode of genetic inheritance by which a dominant gene is carried on the X chromosome.
dominant X-linked dominant inheritance, sometimes referred to as X-linked dominance, is a mode of genetic inheritance by which a dominant gene is carried on the X chromosome.
X-linked
recessive Pathogenic variants in both copies of a gene on the X chromosome cause an X-linked recessive disorder.
recessive Pathogenic variants in both copies of a gene on the X chromosome cause an X-linked recessive disorder.
Mitochondrial or multigenic Mitochondrial genetic disorders can be caused by changes (mutations) in either the mitochondrial DNA or nuclear DNA that lead to dysfunction of the mitochondria and inadequate production of energy.
Multigenic or multifactor Inheritance involving many factors, of which at least one is genetic but none is of overwhelming importance, as in the causation of a disease by multiple genetic and environmental factors.
Not applicable
Categories
Nervous System Diseases
Summary
Transverse myelitis is a neurological disorder caused by inflammation of the spinal cord, which carries nerve signals from the brain to the rest of the body. The segment of the spinal cord that has inflammation or damage determines the symptoms a person has. Generally, inflammation at one segment causes symptoms at that level and below that level. Most commonly, the upper spinal cord is affected, causing impaired leg movement, and problems controlling the bowel and bladder. The onset of symptoms may be acute (sudden, developing over hours or days) or subacute (developing over weeks).[1] The cause of transverse myelitis may be unknown (idiopathic) or it may be associated with a wide variety of underlying health problems, including infections,
Symptoms
From this wide array of symptoms, four classic features of transverse myelitis emerge:[1][4]
Weakness of the legs and arms: Most people with transverse myelitis will experience weakness of varying degrees in their legs; some also experience it in their arms. Initially, people with this condition may notice that they are stumbling, dragging one foot or that both legs seem heavier than normal. Depending on the level of involvement within the spinal cord, coordination or strength in the hands and arms may also be affected.[1][4]
Pain: Up to half of those with transverse myelitis report pain as the first symptom of the disorder. The pain can be localized to the back, or appear as sharp, shooting pain that radiates down the legs, arms or around the torso.[1][4]
Sensory alteration: Loss of the ability to experience pain or temperature sensitivity is one of the most common sensory changes. Patients who are experiencing altered sensitivity usually report numbness, tingling, coldness or burning. Up to 80 percent of people with transverse myelitis experience heightened sensitivity to touch. Some even report that wearing clothes or a light touch with a finger causes significant pain.[1][4] Many also experience heightened sensitivity to changes in temperature or to extreme heat or cold.[1]
Bowel and bladder dysfunction: Some people with transverse myelitis report bowel or bladder dysfunction as their first symptom. This may mean an increased frequency or urge to urinate or have a bowel movement, incontinence, difficulty voiding, sensation of incomplete evacuation or constipation.[1][4]
Cause
The following illnesses or agents have been associated with transverse myelitis:
Infectious agents. Transverse myelitis often develops following viral infections. Infectious agents suspected of causing transverse myelitis include varicella zoster (the virus that causes chickenpox and shingles), herpes simplex, cytomegalovirus, Epstein-Barr, influenza, echovirus, human
Underlying demyelinating disease of the
Vaccinations. Rarely, transverse myelitis may develop following certain vaccinations (hepatitis B, measles-mumps-rubella, and diptheria-tetanus).[5] Although it's unclear how transverse myelitis and vaccinations are related, an immune response is suggested.
Diagnosis
Blood tests may also be performed to rule out various disorders such as systemic lupus erythematosus, HIV infection, and vitamin B12 deficiency. In some patients with transverse myelitis, the cerebrospinal fluid that bathes the spinal cord and brain contains more
Treatment
Chronic pain is a common complication of transverse myelitis. Nonsteroidal anti-inflammatory drugs — such as aspirin, ibuprofen (Advil, Motrin, others) and naproxen (Aleve, Naprosyn, others) — can help reduce inflammation and relieve pain.[6] Bed rest is often recommended during the initial days and weeks after onset of the disorder.[1]
Based on patient response and test results, additional therapeutic options may be added. Plasma exchange therapy is often used for those with moderate to severe transverse myelitis who don’t show much improvement after being treated with intravenous steroids.[4][5] This therapy involves removing the straw-colored fluid in which blood
Some patients respond very well to intravenous cyclophosphamide (a drug often used for lymphomas or leukemia). It is very important that an experienced oncology team be involved in the administration of this drug, and patients should be monitored carefully. Ongoing treatment with chemical agents that modify immune response (such as azathioprine, methotrexate, mycophenolate or oral cyclophosphamide) can be considered for the small subset of patients that experience recurrent transverse myelitis.[4]
Individuals with permanent physical disabilities may benefit from
FDA-Approved Treatments
The medication(s) listed below have been approved by the Food and Drug Administration (FDA) as orphan products for treatment of this condition. Learn more orphan products.
- Baclofen(Brand name: Lioresal® (injection)) Manufactured by Medtronic, Inc.
FDA-approved indication: Management of severespasticity of spinal cord origin in patients who are unresponsive to oral baclofen therapy or experience intolerableCNS side effects at effective doses.
National Library of Medicine Drug Information Portal
Medline Plus Health Information
Organizations
Support and advocacy groups can help you connect with other patients and families, and they can provide valuable services. Many develop patient-centered information and are the driving force behind research for better treatments and possible cures. They can direct you to research, resources, and services. Many organizations also have experts who serve as medical advisors or provide lists of doctors/clinics. Visit the group’s website or contact them to learn about the services they offer. Inclusion on this list is not an endorsement by GARD.
Organizations Supporting this Disease
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Brain & Spine Foundation
LG01, Lincoln House
Kennington Park
1-3 Brixton Road
London, SW9 6DE United Kingdom
Telephone: 0808 808 1000
E-mail: [email protected]
Website: https://www.brainandspine.org.uk/ -
National Multiple Sclerosis Society
733 Third Avenue, 6th Floor
New York, NY 10017-3288
Toll-free: 1-800-344-4867
Telephone: +1-212-986-3240
Fax: +1-212-986-7981
E-mail: [email protected]
Website: https://www.nationalmssociety.org/ -
Siegel Rare Neuroimmune Association (SRNA)
1787 Sutter Parkway
Powell, OH 43065-8806
Toll-free: 1-855-380-3330 (Helpline)
Telephone: +1-614-317-4884
E-mail: https://www.surveymonkey.com/r/MyelitisHelpLine
Website: https://wearesrna.org/
(Formerly the Transverse Myelitis Foundation)
Learn more
These resources provide more information about this condition or associated symptoms. The in-depth resources contain medical and scientific language that may be hard to understand. You may want to review these resources with a medical professional.
Where to Start
- The National Institute of Neurological Disorders and Stroke (NINDS) collects and disseminates research information related to neurological disorders. Click on the link to view information on this topic.
- The National Organization for Rare Disorders (NORD) has a report for patients and families about this condition. NORD is a patient advocacy organization for individuals with rare diseases and the organizations that serve them.
In-Depth Information
- PubMed is a searchable database of medical literature and lists journal articles that discuss Transverse myelitis. Click on the link to view a sample search on this topic.
References
- Transverse Myelitis Fact Sheet. National Institute of Neurological Disorders and Stroke (NINDS). June 24, 2015; https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Transverse-Myelitis-Fact-Sheet.
- Transverse Myelitis. The Transverse Myelitis Association. 2018; https://archive.myelitis.org/resources/Information_Sheets/About_TM.pdf.
- Transverse Myelitis. National Organization for Rare Disorders (NORD). 2015; https://rarediseases.org/rare-diseases/transverse-myelitis/.
- Transverse Myelitis. Johns Hopkins University Transverse Myelitis Center. https://www.hopkinsmedicine.org/neurology_neurosurgery/centers_clinics/transverse_myelitis/about-tm/what-is-transverse-myelitis.html.
- Transverse Myelitis. MayoClinic.com. https://www.mayoclinic.org/diseases-conditions/transverse-myelitis/basics/causes/con-20028884?p=1.
- Transverse Myelitis: Treatments and drugs. MayoClinic.com. February 13, 2014; https://www.mayoclinic.com/health/transverse-myelitis/DS00854/DSECTION=treatments-and-drugs.
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