Transverse myelitis is a rare condition that causes inflammation of the spinal cord. This inflammation damages the protective covering of nerve cells, called the myelin sheath. The myelin sheath protects your nerves and allows electrical signals to travel between your spinal cord and the rest of your body.
UPMC neurology experts provide advanced care for transverse myelitis, including medications, plasma exchange, intravenous immunoglobulin therapy, pain management and rehabilitation.
On this page:
What Is Transverse Myelitis?
Transverse myelitis is a rare condition that causes inflammation of the spinal cord. This inflammation damages the protective covering of nerve cells, called the myelin sheath. The myelin sheath protects your nerves and allows electrical signals to travel between your spinal cord and the rest of your body.
Damage to the myelin sheath can cause neurological symptoms, including muscle weakness, numbness, pain, and bladder problems. People with transverse myelitis often report a horizontal band-like sensation around their body just below the damaged area of the spinal cord, with symptoms occurring on both sides of the body below the band.
How common is transverse myelitis?
Transverse myelitis is a rare condition. According to statistics from the National Multiple Sclerosis Society, it affects approximately one to 5 people per million each year, resulting in approximately 1,400 new diagnoses each year in the U.S.
What causes transverse myelitis?
Transverse myelitis is caused by spinal cord inflammation, which damages the protective covering of your nerve cells.
The inflammation itself can be idiopathic (having no known cause), or be caused by:
- Autoimmune conditions — Common causes include rheumatoid arthritis, sarcoidosis, scleroderma, Sjögren’s disease, lupus, ankylosing spondylitis, and more.
- Central nervous system conditions — Common causes include multiple sclerosis, neuromyelitis optica spectrum disorder, myelin oligodendrocyte glycoprotein antibody disorders, and acute disseminated encephalomyelitis.
- Infections — Common causes include enteroviruses, herpes, HIV, varicella-zoster (chicken pox and shingles), Lyme disease, Zika virus, West Nile virus, syphilis, tuberculosis, bacterial pneumonia, and more.
Transverse myelitis risk factors
You may be at higher risk for transverse myelitis if you have been diagnosed with an autoimmune or central nervous system condition or have had a recent infection. In some cases, transverse myelitis is the first symptom of a central nervous system or autoimmune condition.
Complications of transverse myelitis
Transverse myelitis may cause permanent disability that ranges from problems with walking and bowel or bladder issues to complete paralysis.
How can I prevent transverse myelitis?
There is nothing you can do to prevent transverse myelitis.
What Are the Signs and Symptoms of Transverse Myelitis?
Symptoms of transverse myelitis typically develop over several weeks, sometimes within hours or days. They can quickly become severe and affect parts of the body below the damaged area of your spinal cord.
People with transverse myelitis often report a horizontal band-like sensation around their body just below the damaged area of the spinal cord, with symptoms occurring on both sides of the body below the band.
Symptoms may include:
Abnormal sensations
Abnormal sensations include:
- Burning.
- Loss of or increased sensitivity to temperature or touch.
- Numbness.
Pain
Pain symptoms may:
- Feel achy, dull, or sharp.
- Feel like a band around your chest or abdomen.
- Radiate down your arms and legs.
Bowel and bladder problems
Bowel and bladder symptoms may include:
- Constipation.
- Difficulty emptying your bladder.
- Loss of bladder control.
- Urine leakage.
- Urgent need to urinate.
Movement and muscle problems
Depending on the part of your spinal cord affected, transverse myelitis may cause weakness that begins in your arms or legs and rapidly worsens.
Other symptoms may include:
- Difficulty walking.
- Loss of balance.
- Loss of muscle function.
- Muscle spasms.
Other symptoms
Other symptoms of transverse myelitis may include:
- Difficulty breathing.
- Fever.
- Headache
- Loss of appetite.
- Sexual problems.
When should I see a doctor about my transverse myelitis symptoms?
If you have symptoms of transverse myelitis, you should dial 911 or go to the nearest hospital Emergency Department. Getting early treatment can reduce your risk of permanent damage or serious complications.
How Do You Diagnose Transverse Myelitis?
To diagnose transverse myelitis, your doctor will perform physical and neurological examinations and review your symptoms and medical history. Your doctor may also order tests to confirm your diagnosis or rule out other problems.
What to expect during your visit
During your visit, your doctor will:
- Ask you about your symptoms.
- Order tests.
- Perform a physical and neurological exam.
- Review your medical history.
Tests to diagnose transverse myelitis
Your doctor may order tests to gather information or rule out other conditions, including:
- Blood and urine tests — Checks for abnormalities and rules out other conditions.
- Cerebral spinal fluid analysis (spinal tap or lumbar puncture) — Involves inserting a needle into your lower back to collect a sample of cerebrospinal fluid (CSF) for analysis in a lab.
- Magnetic resonance imaging (MRI) — Creates images of your brain and spine using contrast dye to look for damaged or abnormal areas.
- Neurological examination — A noninvasive test to check your reflexes, balance, movement, memory, and ability to think.
Transverse myelitis prognosis
Most people experience only one episode of transverse myelitis. However, people who have autoimmune or central nervous system disorders may experience more than one episode.
About one-third of people make a complete recovery, one-third have moderate disability, such as difficulty walking, and one-third have permanent paralysis.
Your prognosis depends on the severity of your symptoms, the rate at which they develop, the location of the nerve damage, the rate at which your condition improves, and other factors. Your doctor will discuss your prognosis with you.
What is the survival rate for transverse myelitis?
Nearly all people who are diagnosed with transverse myelitis survive, but some may have permanent damage that ranges from mild to severe.
Can transverse myelitis be reversed?
Damage caused by transverse myelitis may not be fully reversable, but about two-thirds of people are able to recover partially or completely. Getting early treatment may improve your chances of recovery.
How Do You Treat Transverse Myelitis?
The goals of transverse myelitis care are to treat the underlying cause if known, reduce inflammation, relieve symptoms, and decrease the risk of long-term complications. Treatment typically involves short-term care to treat acute symptoms and long-term care to manage complications.
Short-term transverse myelitis care
Short-term transverse myelitis care may include:
- Intravenous immunoglobulin therapy (IVIG) — During IVIG, you will receive an intravenous injection of donor immunoglobulins. Immunoglobulins are a natural part of your immune system and protect your body by attacking foreign organisms. Immunoglobulins may prevent your immune system from further damaging your nerves.
- Medication — Corticosteroids given through an IV may reduce inflammation in your spinal cord. Your doctor may also prescribe medications to suppress your immune system or manage other symptoms.
- Plasma exchange (plasmapheresis) — Plasmapheresis involves using a machine to separate the liquid part of your blood, called plasma, from your blood cells. Your plasma is then filtered to remove the antibodies that are causing nerve damage before being returned to your body.
Long-term transverse myelitis care
Long-term transverse myelitis care may include:
- Bowel and bladder care — Includes treatments to improve bowel and bladder function.
- Mental health care — Includes treatments for depression or anxiety, including medication and talk therapy.
- Pain management — Medications may be used to treat muscle and nerve pain.
- Rehabilitation — Although damage caused by transverse myelitis is irreversible, physical and occupational therapy can help improve stiffness, mobility, strength, balance, and overall function.
- Sexual health care — Treatments may include medication for erectile dysfunction and other sexual problems.
- Skin care — Involves preventing pressure ulcers (bedsores) and skin infections.
Why Choose UPMC for Transverse Myelitis Care?
When you choose UPMC for transverse myelitis care, you will receive:
- Multidisciplinary care — Our team of neurologists and autoimmune disease experts will work together to develop a customized treatment plan that reduces your risk of complications.
- Access to advanced clinical trials — Our team participates in national, multicenter clinical trials evaluating new treatment options, enabling you to contribute to research that advances care for autoimmune and central nervous system disorders.
- Seamless, ongoing treatment — If you are diagnosed with transverse myelitis, our team will develop a follow-up care plan that includes ongoing rehabilitation and symptom management as needed.
