Transverse Myelitis is a rare neurological condition involving inflammation of the spinal cord. There are a wide variety of symptoms involving sensory, motor and autonomic dysfunction. Symptoms usually develop rapidly over a period of hours or they can develop gradually over a period of several weeks.
TM is not common – it is estimated that there are no more than 300 new cases per year. The rarity of the disorder, together with the variable presentation of symptoms, complicates the diagnosis for GPs and Casualty staff.
Symptoms can include abnormal sensations (such as tingling, numbness, banding), pain radiating from the spine, weakness in arms and or legs, bowel and bladder dysfunction, fatigue, fever and partial or total paralysis.
Diagnosis and Treatment
Diagnosis relies on patient history, physical examination, MRI, lumbar puncture and blood tests.
Treatment in the acute phase may include high-dose IV corticosteroids. Approximately, one third of patients will recover with little or no sequelae, one third are left moderately disabled and one third are left severely disabled.
Once the acute phase of TM subsides, patients will usually require physiotherapy to improve strength, mobility and to manage spasticity and improve sensation. There is more information about the role of physiotherapy in TM here.
Many TM patients experience continuing neuropathic pain that may respond poorly to narcotics, or may require anti-spasticity drugs, or continue to have some degree of bladder and bowel dysfunction and may become clinically depressed, irrespective of their level of disability.
Further sources of information
The UK's Brain & Spine Foundation has prepared a 24-page downloadable booklet called Transverse Myelitis. The booklet is an excellent source of comprehensive information.
The TM Society Introductory Leaflet is a downloadable two page document with a concise description of the disease and information about the TM Society and the Support Group network.
The TM Society has produced a comprehensive set of FAQs which is available here.
The Transverse Myelitis Association is the world-wide organisation for TM and related rare autoimmune neurological diseases. This organisation is based in the USA and has close associations to medical and research communities specialising in neurological disorders. Their website is a good source of scientific information and articles on symptoms, treatments and the related conditions of RTM, ADEM, NMO and Optic Neuritis (ON).