Transverse Myelitis and MS

Transverse myelitis can appear as the first symptom in conditions such as multiple sclerosis (MS) or neuromyelitis optica (NMO).

TM is sometimes a feature of relapsing-remitting multiple sclerosis (MS). This type of TM may be associated with demyelination or focal inflammation in the white matter of other regions of the central nervous system. In the past, many patients with monophasic forms of TM were erroneously classified as MS and, likewise, some MS patients were misdiagnosed as TM.

The right diagnosis is critical for future management as treatment strategies may be very different for patients with MS compared to those with TM. In patients diagnosed with TM, a brain MRI and CSF studies are quite important to clarify the presence of MS. Brain MRI may help to identify the existence of areas of demyelination in other regions of the central nervous system other than the spinal cord. CSF studies may be helpful to determine if antibodies are being synthesized within the central nervous system (e.g., oligoclonal bands), a finding that may support a diagnosis of MS.

Transverse myelitis is often a onetime illness. But for some people, transverse myelitis is an early symptom of another serious disease of the nervous system. One such disease is multiple sclerosis (MS).

MS is a chronic disease with no cure. It occurs when the body’s immune system attacks the central nervous system. MS can affect various parts of your body, including:

• brain
• eyes
• limbs

The severity of symptoms varies from person to person.

Partial myelitis
Transverse myelitis means both sides of a cross-section of the spinal cord are inflamed. Partial myelitis, which affects only one side of the cross-section, is more commonly a symptom of MS.

But the National Institute of Neurological Disorders and Stroke recommends that anyone with transverse myelitis or partial myelitis get checked for MS.

Symptom similarities and differences
MS and transverse myelitis share some common symptoms, such as a tingling sensation in the arms and legs.

There are also some significant differences between MS and transverse myelitis:

Transverse myelitis symptoms
People with transverse myelitis often experience back pain as their first symptom. Extreme sensitivity to touch is also present in about 80 percent of people with transverse myelitis, according to the National Multiple Sclerosis Society.

MS symptoms
MS symptoms usually include:

• numbness or weakness in the limbs
• vision problems
• loss of coordination

Causes of transverse myelitis and MS
The causes of transverse myelitis aren’t completely understood. The National Institute of Neurological Disorders and Stroke suggests that the disease may be caused by an infection. The National Multiple Sclerosis Society reports that MS also may be caused by an immune system response.

Diagnosis
A doctor usually orders magnetic resonance imaging (MRI) to diagnose transverse myelitis. An MRI of your spinal cord will show inflammation. It will help your doctor determine whether your pain is from a slipped disc or another condition like MS.

For a proper diagnosis, the doctor must get your medical and family history. A neurological exam is also required to diagnose transverse myelitis and MS.

Treatment and recovery
Treatment for transverse myelitis often begins with drugs to decrease inflammation. Since moving your limbs is important to help keep them healthy, you will also likely receive physical therapy to help repair nerve damage.

Waiting to get treatment is dangerous. The sooner you are treated after symptoms appear, the better your chance of recovery.