Acute Transverse Myelitis

The acute transverse myelitis is an acute inflammation of the gray and white matter in one or more adjacent thoracic generally, spinal cord segments. Causes are autoimmune inflammatory processes such as multiple sclerosis, neuromyelitis optica, vasculitis or other systemic autoimmune diseases, infections or post-infectious inflammation and certain medications. Symptoms include bilateral motor, sensory and autoimmune deficits below the lesion. The diagnosis is usually based on MRI, CSF analysis and blood tests. used early, intravenous corticosteroids and plasmapheresis may be helpful. Otherwise the treatment of supportive measures and the elimination of all causes.

(See also overview of diseases of the spinal cord.)

The acute transverse myelitis is an acute inflammation of the gray and white matter in one or more adjacent thoracic generally, spinal cord segments. Causes are autoimmune inflammatory processes such as multiple sclerosis, neuromyelitis optica, vasculitis or other systemic autoimmune diseases, infections or post-infectious inflammation and certain medications. Symptoms include bilateral motor, sensory and autoimmune deficits below the lesion. The diagnosis is usually based on MRI, CSF analysis and blood tests. used early, intravenous corticosteroids and plasmapheresis may be helpful. Otherwise the treatment of supportive measures and the elimination of all causes. (See also overview of diseases of the spinal cord.) An acute transverse myelitis is usually caused by multiple sclerosis, but it can also occur in vasculitis, mycoplasma infections, Lyme disease, syphilis, tuberculosis or viral Meningomyeloenzephalitis or in patients amphetamines, heroin iv taking or antiparasitic medications or antifungal agents. Transverse myelitis occurs with optic neuritis in neuromyelitis optica on (Devic’s disease), the former is considered a variation of multiple sclerosis, but now regarded as a separate disorder. The pathogenic mechanism of transverse myelitis is often unknown, but they do occur in some cases after a viral infection or after vaccination, suggesting an autoimmune etiology. The inflammatory response damages the spinal cord diffusely on one or more segment heights and affects all spinal cord functions. Symptoms and complaints It can cause pain in the neck, back or head occur. A belt-shaped tightness around the chest or abdomen, weakness, tingling and tingling, numbness in the feet and legs and difficulty in voiding develop over hours to a few days. The deficits can then proceed and for several days to a complete sensorimotor paraplegic syndrome cause paraplegia with loss of sensitivity below the lesion, urinary retention and fecal incontinence. Occasionally, the position and the vibration sense are recessed, at least initially. The syndrome occurs occasionally in patients with multiple sclerosis, SLE, or antiphospholipid syndrome repeatedly. Diagnostic MRI and CSF analysis Other tests to identify treatable causes Diagnosis of acute transverse myelitis is suspected at a sensorimotor Querschnittsmyelopathie with segmental deficits. Guillain-Barre Syndrome can differentiate itself because it does not occur locally in an isolated spinal segment. For diagnosis, an MRI and a CSF analysis are needed. Is a transverse myelitis before, the MRI typically shows a swelling of the spinal cord and helps to exclude other treatable causes a malfunction of the spinal cord (z. B. spinal cord compression). The CSF usually contains monocytes, the protein content is slightly increased, and the IgG index is elevated (normal ? 0.85). (Editor’s note:.! The cerebrospinal fluid contains increased LYMPHOCYTES [= lymphocytic pleocytosis], increased monocytes [Monocytosis] is not typical of an autoimmune or viral myelitis case of bacterial infection are overexpressed GRANULOCYTE [granulocytic pleocytosis]) high specific a test a marker for neuromyelitis optica-IgG (NMO-IgG) -a autoantibodies to the astrocytic water channel protein aquaporin-4, which helps to distinguish NMO from multiple sclerosis. The tests for treatable causes should include: chest X-ray, tuberculin test, serological tests for mycoplasma, Lyme disease and HIV, vitamin B12, folic acid, zinc and copper levels, erythrocyte sedimentation rate, antinuclear antibodies and VDRL test in CSF and blood. Because of the history of medicine may be suspected as the cause. An MRI of the brain is performed; a multiple sclerosis patient develops in 50% with multiple periventricular lesions on T2-weighted sequence and in 5% of patients who do not show this. Prognosis In general, the prognosis is poorer, the faster the progression is. Pain speaks for a more intense inflammation. About a third of patients recover, one third remain a certain weakness and urge incontinence and one third is bedridden and incontinent. A multiple sclerosis eventually develops in about 10-20% of patients in whom the cause is initially unknown. Treatment treatment of the cause Sometimes corticosteroids Management of acute transverse myelitis is determined by the cause or an associated disease, otherwise it is supportive. In idiopathic cases, often high-dose corticosteroids are given, and sometimes plasma exchange connects as an autoimmune cause may be. The effectiveness of such an approach is not assured. Conclusion Autoimmune and demyelinating diseases, infections and drugs can cause in spinal cord segments tissue inflammation that cause transverse myelitis, which can progress to komlpetten sensorimotor Querschnittsmyelopathie. Perform an MRI of the spinal cord, a cerebrospinal fluid, a test for neuromyelitis optica-IgG and other tests for treatable causes (eg. As infections, malnutrition). Treat the cause, if it is identified, and consider if no cause is apparent, corticosteroids and plasma exchange.

Health Life Media Team

Leave a Reply