Myelitis may be a painful and complicated disease, but in can be treated. And from diagnosis of the disease to treatment motivation and will power would be the main strength for a patient.
Overview of myelitis:
- Myelitis involves the infection or the inflammation of the white matter or gray matter of the spinal cord which is a part of the central nervous system that acts as a bridge between the brain and the rest of the body.
- During an inflammatory response in the spinal cord, the myelin and axon may get damage which can cause symptoms such as paralysis and sensory loss.
- Myelitis can be divided into certain types depended on the area of the cause of inflammation.
- Myelitis mainly occurs in narrow region that can go and spread to other broad regions.
Symptoms of myelitis:
The symptoms of early myelitis can be-
- Pain in your lower back
- Weakness or paralysis in your legs or arms
- Sensitivity to touch to the point where slight fingertip pressure causes pain
- Numbness or a pins-and-needles feeling in your toes, feet, or legs
- Problems controlling your bladder or bowels
- Muscle spasms
- Loss of appetite
With the coming of symptoms the symptoms can go worse within some hours. But in most case, the symptoms hit peaks in 10 days.
Myelitis is most common in younger people within the age of 10 to 19 and from 30 to 39 are at higher risk. Like multiple sclerosis, myelitis is common in women than men.
Types of myelitis:
- Poliomyelitis-Disease caused by infection in gray matter which shows symptoms of muscle paralysis and weakness.
- Transverse myelitis-It occurs when both side of one section of the spinal cord gets damaged. Many times the covering of the nerve cells, the myelin gets damaged.
- Meningococcal Myelitis (or meningomyelitis): lesions occurring in the region of meninges and the spinal cord
Though there are three types of myelitis the most common myelitis is the transverse myelitis an doctors, and people often refer to any inflammatory attack in spinal cord as transverse myelitis.
Causes of myelitis:
The exact reason of myelitis is not known. But there are certain conditions which can cause inflammation. They are-
- Virus or other infection-Recent infection in respiratory tract or gastrointestinal tract can cause myelitis. Mostly myelitis occurs after infection is over.
- Viruses that can infect the spinal cord directly are herpes viruses, including the one that causes shingles and chickenpox (zoster), enteroviruses, and West Nile virus.
- Other viruses may trigger an autoimmune reaction without directly infecting the spinal cord.
- Parasites may infect the spinal cord in a rare condition, and some bacteria such as that of Lyme disease can cause a painful inflammation in the nerve roots of the spinal cord.
- Multiple sclerosis-It is a disease when the body's immune system affects the spinal cord cells. Transverse myelitis can be the first sign of multiple sclerosis.
- Neuromyelitis optica (Devic's disease) -It is a condition that causes inflammation and myelin loss around the spinal cord and the nerve in the eye.
- Transverse myelitis can be associated with neuromyelitis optica,which can affect both side of the body and can lead to eye problems even temporary vision loss.
- However people may not have any symptoms of Neuromyelitis optica, only can show symptoms of Myelitis.
- Autoimmune disease-It can cause myelitis in some people.As, antibody affection the spinal cord can sometime lead to transverse myelitis.
- Vaccinations -using vaccines for infectious diseases including hepatitis B, measles-mumps-rubella and diphtheria-tetanus vaccines have occasionally been associated as a possible trigger.
Treatments of Myelitis-
- Intravenous steroids: Steroids are given to reduce inflammation in the spinal column.
- Plasma exchange therapy: Patient snot responding to steroids may be given therapy of plasma exchange.Here the plasma in bone marrow is replaced with another fluid.
- Antiviral medication. Patients having myelitis from viral infection can be treated with medicines against virus.
- Therapy against complications:
- Pain medication. Chronic pain is a common complication of transverse myelitis. Medications that may lessen muscle pain include common pain relievers, such as acetaminophen (Tylenol, others), ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve.)
- Nerve pain may be treated with antidepressant drugs, such as sertraline (Zoloft), and anticonvulsant drugs, such as gabapentin (Neurontin, Gralise) or pregabalin (Lyrica).
- People who have been diagnosed with antibody against neuromyelitis optica should undergo medications for that such as corticosteroids and/or immunosuppressant, to reduce their chances of more transverse myelitis attacks or developing optic neuritis.
- Psychotherapy-To deal with anxiety, derpression and long term complications which may affect the patient's emotions.
Diagnosis of myelitis:
- Magnetic resonance imaging (MRI) -It uses a magnetic field and radio waves to create 3-D images of soft tissues. An MRI can show inflammation of the spinal cord, and other potential causes of the symptoms, including abnormalities affecting the spinal cord or blood vessels.
- Lumbar puncture (spinal tap) -In this technique a needle is used to draw small amount of cerebrospinal fluid (CSF), the protective fluid surrounding the spinal cord and brain. People with transverse myelitis, show abnormally high level of white blood cells in CSF or immune system proteins that indicate inflammation.
- Blood tests-Antibody blood tests can be done which checks for antibodies associated with neuromyelitis optica.
Complications of myelitis-
People with transverse myelitis can experience complications for further long periods which are:
- Pain, one of the most common long-term complications of the disorder.
- Stiffness, tightness or painful spasms in the muscles (muscle spasticity). This is most common in the hips and legs.
- Partial or total paralysis of your arms, legs or both. This may persist after the first symptoms.
- Sexual dysfunction, it can be common complication for both men and women.
- Depression or anxiety, which is common in those with long-term complications .It is because of the significant changes in lifestyle, the stress of chronic pain or disability and the impact of sexual dysfunction, Overview Diagnosis