Transverse Myelitis (TM) is a rare neurological disorder of the spinal cord, caused by inflammation and occurring across one spinal segment, leading to severe motor, sensory and autonomic dysfunction.
The term Transverse Myelitis (TM) was first coined in 1948 by Dr Suchett-Kaye, an English neurologist. He uses this to describe a case of rapidly progressive paraparesis with a thoracic sensory level, occurring as a post-infectious complication of pneumonia.
The incidence of TM is 1 (severe) to 8 (mild) cases/million per year. It occurs in adults and children, in both genders, and in all races. A peak in incidence rates (the number of new cases per year) appears to occur between 10 and 19 years and 30 and 39 years.
The mechanism of injury is inflammation of the spinal cord causing damage to the myelin sheath of the nerves.
Signs and symptoms of transverse myelitis usually develop over a few hours to a few days and may sometimes progress gradually over several weeks.
Transverse myelitis usually affects both sides of the body below the affected area of the spinal cord, but sometimes there are symptoms on just one side of the body.
What Causes Transverse Myelitis?
The root cause of Transverse Myelitis is still a mystery and in some cases there is no cause ever found for this condition, although there are some causes which have been attributed to development of Transverse Myelitis. These causes are:
Viral Infections: Viral infections of the respiratory tract and the GI tract have been shown to cause Transverse Myelitis with this condition developing after being fully recovered from the infection. There are some types of viruses that directly affect the spinal cord like the herpes virus, herpes zoster virus, West Nile virus and the like.
Multiple Sclerosis: Disease like multiple sclerosis is known to cause Transverse Myelitis as this is a disorder that tends to destroy the myelin in the spinal cord and the brain. In fact, in some cases Transverse Myelitis is a defining symptom of Multiple sclerosis.
Neuromyelitis Optica: This is also a medical condition which is known to cause Transverse Myelitis. This condition results in myelin loss around the spinal cord.
Autoimmune Disorders: Certain autoimmune disorders have also been known to cause Transverse Myelitis. Some of the disorders are lupus or Sjogren's syndrome.
Vaccinations: In some cases vaccinations for various diseases have also caused Transverse Myelitis. Some of the vaccinations causing this condition are vaccinations for hepatitis B, MMR vaccination, diphtheria, and tetanus vaccines.
Symptoms
Typical signs and symptoms include:
-Pain
-Abnormal sensation
-Weakness in your arms or legs
-Bladder and bowel problems
-Depression or anxiety
Treatment
To rehabilitate patient a multidisciplinary team work for better treatment.
-Neurologist
-Occupational Therapist
-Physiotherapist
-Speech and Language Therapist
-Social worker
Role of occupational therapy
Occupational therapy is a type of health care that helps to solve the problems that interfere with a person’s ability to do the things that are important to them – everyday things like:
Self-care - getting dressed, eating, moving around the house,
Being productive - going to work or school, participating in the community, and Leisure activities - sports, gardening, social activities.
Occupational therapy can also prevent a problem or minimize its effects.
Patient with transverse myelitis have the problem to do daily activities. Occupational therapist plays a great role to rehabilitate these patients.
Occupational therapy teaches patients new ways to maintain or rebuild their independence by participating in meaningful, self-directed, everyday tasks.
Therapists teach people how to function at the highest level possible, by developing coping strategies, suggesting changes in their homes to improve safety (such as installing grab bars in bathrooms), and changing obstacles in their environment that interfere with normal activity.
Other therapeutic treatment includes:
-Strengthening practice with activity
-Transferring
-Gait retraining
-Wheelchair training
-Reduce risk of pressure ulcers by properly educate the patients
-Aid control of spasticity
-Pain reduction/management
-Home environment modification
Prognosis
Some case series have estimated that approximately one third of patients recover with few or no lasting effects; another third have a moderate degree of residual disability, and one third remain severely disable.