Myelitis Mysteries: Understanding Its Diverse Forms

Myelitis is a state of inflammation in an individual's spinal cord that can result in permanent nerve and spinal damage. Causes include damage from other diseases, abnormal autoimmune responses, certain types of viruses and bacteria, vascular abnormalities, and cancer. Symptoms vary depending on which section of the spinal cord is being affected and damaged from the inflammation. Examples include back pain, numbness, tingling, urinary urgency, bowel or bladder incontinence, abdominal tightness, muscle weakness, paralysis, loss of light touch sensation, and constipation. Myelitis is diagnosed with blood tests, diagnostic MRI imaging, physical exam, and lumbar puncture.

Myelitis treatment is essential. Common options include corticosteroids for transverse myelitis. Other medications for myelitis may be helpful. Patients often need occupational therapy or physical therapy for myelitis as well. However, the best treatment for myelitis varies depending on the specific type. Thus, patients must understand the major types of myelitis first.

Transverse Myelitis

Transverse myelitis is a type where the patient experiences nerve dysfunction on both sides of their spinal cord in both the sensory and motor pathways. There are a handful of classic symptoms that occur in individuals with this condition. Symptoms include arm and leg weakness, tingling sensations, discomfort or pain, numbness, bladder dysfunction, and bowel motility issues. These symptoms may occur bilaterally, which means they appear in both arms and legs. However, they may also occur unilaterally, meaning in the arm and leg on one side of the body.

The word transverse in the name of this condition refers to malfunction at a single level across the entire spinal cord. Inflammation that is focal and produces unilateral dysfunction is included in this myelitis classification. Most cases of transverse myelitis have an unknown cause. The ones that do are often the result of an autoimmune disorder. Examples include neuromyelitis optica, Sjogren's syndrome, andmultiple sclerosis.

Leukomyelitis

Leukomyelitis describes inflammation of the spinal cord limited to an individual's white matter. The brain and spinal cord are composed of various types of tissue that perform different functions. Gray matter contains dendrites, neural cells, and axon terminals. White matter contains myelin and axons. The white matter may also be referred to as superficial tissue. This is due to its location in the outer parts of the spinal cord and brain. White matter regulates and transmits nerve signals from the cerebrum to the spinal cord and other brain tissues. Within the spinal cord, white matter functions as a complex network of wiring that carries information throughout the central nervous system. When this white matter in the spinal cord becomes inflamed, it is called leukomyelitis.

Some of the most common causes of this condition are cerebral palsy, multiple sclerosis, and other inherited childhood diseases. When there is inflammation in the white matter of the spinal cord, the effectiveness of a patient's blood-brain barrier becomes compromised. This process allows for further infiltration of the central nervous system by antibodies and peripheral immune cells. This compounded inflammation can damage the protective myelin sheathing that insulates the neural axons and allows for the smooth transmission of signals.