Transverse Myelitis Prognosis
Although most people with transverse myelitis have at least partial recovery, it may take a year or more. Most recovery occurs within the first three months after the episode and strongly depends on the cause of transverse myelitis.
About one-third of people with transverse myelitis fall into one of three categories after an attack:
- No or slight disability. These people experience only minimal lingering symptoms.
- Moderate disability. These people are mobile, but may have difficulty walking, numbness or tingling, and bladder and bowel problems.
- Severe disability. Some people may permanently need a wheelchair and require ongoing assistance with daily care and activities.
It’s difficult to predict the course of transverse myelitis. Generally, people who experience a rapid onset of signs and symptoms have a worse prognosis than do those with a relatively slower onset.
Treatment and recovery
As with many disorders of the spinal cord, no effective cure exists for people with transverse myelitis. The best medicine has to offer is symptom management.
Therapy generally begins when the patient first experiences symptoms. Physicians may prescribe steroids during the first few weeks of illness to decrease inflammation.
The goal is to keep the body functioning, hoping for complete or partial spontaneous recovery of the nervous system. Some who don’t respond to steroids may undergo plasma exchange therapy (plasmapheresis). This involves replacing plasma, thus removing antibodies that may be involved in inflammation.
People with acute symptoms, such as paralysis, are most often treated in a hospital or in a rehabilitation facility under the care of a specialized medical team. Later, if patients begin to recover limb control, physical therapy is then integrated to help improve muscle strength, coordination, and range of motion begins.
Recovery from transverse myelitis usually begins within two to 12 weeks of the onset of symptoms and may continue for up to two years. However, if there is no improvement within several months, significant recovery is unlikely.
About one-third of people affected with TM experience good or full recovery. Another one-third show fair recovery and are left with deficits such as spastic gait, sensory dysfunction, and urinary urgency or incontinence. The remaining one-third show no recovery, using wheelchairs, perhaps with dependence on others for basic functions of daily living.