Myelitis

General Discussion ------------------ Myelitis is a disorder of the spine marked by inflammation of the spinal cord. When inflammation is very limited, the condition may be called a "myelopathy". Injury to the spine, benign tissue growths, or blood vessel abnormalities may also cause this disorder. Major symptoms may initially include pain, followed by gradual paralysis and/or other central nervous system disturbances. Synonyms -------------------------------- Myelopathy DISORDER SUBDIVISIONS Acute Transverse Myelitis Ascending Myelitis Brown-Sequard Syndrome Concussion Myelitis Foix-Alajouanine Myelitis (Subacute Necrotizing Myelitis) Funicular Myelitis Systemic Myelitis Transverse Myelitis Information on the following diseases can be found in the Related Disorders section of this report: Spinal Stenosis Cervical Spondylosis Myelitis is characterized by inflammation of segments of the spinal cord which can cause local back pain, usually followed by gradual spinal cord dysfunction. These symptoms are often accompanied by muscle spasms, a general feeling of discomfort, backache, headache, loss of appetite (anorexia), numbness or tingling of legs. Eventually, loss of sensation may be severe, associated with sensorimotor paralysis below the level of the lesion, urinary retention, and loss of sexual function and/or bowel (sphincter) control. Myelitis patients exhibit thick, rough, dry skin below the spinal lesion, and tendon reflexes may be lost. The upper spinal (thoracic) area is often involved, causing abdominal paralysis. Eventually, there may be slight improvement depending on the cause. Myelitis can be an acute or chronic disease. Ascending Myelitis is marked by progression of paralysis and loss of sensation over time. In Transverse Myelitis, congestion or obstruction of blood vessels, swelling, cellular infiltration or loss, and loss of the fatty tissue around the nerves (demyelination) may be seen on examining the involved segment of the spinal cord. Disseminated Myelitis is characterized by more than one spinal cord lesion. Brown-Sequard Syndrome involves spinal cord compression and lesions associated with inflammation, injury, presence of foreign bodies, or Meningovascular Syphilis. Only half of the spinal cord is involved. Causes ------ Although the cause of Myelitis is not known in many cases, it can be caused by viral infections, spinal cord injuries, immune reactions, or insufficient blood flow through the blood vessels in the spinal cord. It can occur as a complication of loss of nerve sheath tissue (demyelination) particularly in Optic Neuromyelitis or Multiple Sclerosis. It can also be a complication of reactions to Smallpox, Measles, or Chickenpox vaccinations. Myelitis can be a symptom of Neurovascular Syphilis or Acute Encephalomyelitis (inflammation of the brain and spinal cord). Affected Population ------------------- Myelitis can begin at any time of life. It affects males and females in equal numbers. Related Disorders ----------------- Symptoms of the following disorders can be similar to those of Myelitis. Comparisons may be useful for a differential diagnosis: Spinal Stenosis is an uncommon form of Sciatica (disease of the sciatic nerve roots) which is characterized by severe pain in the lower back extending to the buttocks, thighs or calves. This pain is especially noticeable when walking, running or climbing stairs. Some limping or lameness may develop. Spinal Stenosis is often associated with spinal disk abnormalities usually following other illnesses or injuries. Pain may be somewhat relieved by resting, or in more severe cases surgery may be necessary. This disorder usually occurs in middle-aged or elderly persons. (For more information on this disorder, choose "Spinal Stenosis" as your search term in the Rare Disease Database). Cervical Spondylosis is a degenerative spinal disease in which disk spaces collapse followed by thickening of ligaments and bony over-development leading to nerve root compression and narrowing of the spinal canal. Intermittent neck pain may spread to the shoulders and arms, possibly limiting motion. Therapies: Standard -------------------- Corticosteroid drugs may be helpful treatment for spinal cord inflammation in Myelitis patients. Surgery may be necessary in some cases. Other treatment is symptomatic and supportive. Therapies: Investigational --------------------------- Experimental electric stimulation treatment is under investigation for treating some cases of Myelitis. The multiprogrammable spinal cord stimulator involves epidural spinal electrostimulation (ESES). This is an experimental medical device under evaluation for control of motor dysfunction. This device can be surgically implanted in the spine and may be of therapeutic benefit to patients with some types of Myelitis or Myelopathy as well as other neuromuscular disorders that do not respond to more conventional therapies. The goal is to increase the range of mobility while alleviating muscle spasms and pain. This disease entry is based upon medical information available through April 1989. Since NORD's resources are limited, it is not possible to keep every entry in the Rare Disease Database completely current and accurate. Please check with the agencies listed in the Resources section for the most current information about this disorder. Resources --------- For more information on Myelitis, please contact: Transverse Myelitis Association c/o Deanne Gilmur 3548 Tahoma PL W Tacoma, WA 98466-2141 Phone: +1 (253) 565-8156

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Email: info@myelitis.org WWW: http://www.myelitis.org National Organization for Rare Disorders (NORD) P.O. Box 8923 New Fairfield, CT 06812-1783 (203) 746-6518 (203) 746-6927 (TDD for the hearing impaired) American Paraplegia Society 75-20 Asatonia Blvd. Jackson Heights, NY 11370-1177 (718) 803-3782 Spinal Cord Society 2410 Lakeview Drive Fergus Falls, MN 56537 Spinal Cord Injury Hotline 2201 Argonne Drive Baltimore, MD 21218 24-Hour-Hotline 1-800-526-3456 In Maryland, 1-800-638-1733 NIH/National Institute of Neurological Disorders & Stroke (NINDS) 9000 Rockville Pike Bethesda, MD 20892 (301) 496-5751 (800) 352-9424 NIH/National Institute of Allergy and Infections Diseases (NIAID) 9000 Rockville Pike Bethesda, MD 20892 (301) 496-5717 References ---------- ACUTE TRANSVERSE MYELOPATHY IN CHILDHOOD: K. Dunne, et al.; Dev Med Child Neurol (April 1986, issue 28(2)). Pp. 198-204. RECURRENT TRANSVERSE MYELITIS ASSOCIATED WITH COLLAGEN DISEASE: M Yamamato; J Neurol (June 1986, issue 233(3)). Pp. 185-187. EVOKED POTENTIALS IN ACUTE TRANSVERSE MYELOPATHY: C.H. Wulff; Dan Med Bull (October 1985, issue 32(5)). Pp. 282-286. Please consult Entrez PubMed MEDLINE database of references to the biomedical literature, to search for the most recent information on Myelitis.

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