The spinal cord is one of the most vital parts of the nervous system, transmitting messages between the brain and the rest of the body. When it becomes inflamed, a serious condition known as myelitis develops. This inflammation can interfere with communication signals, leading to pain, weakness, numbness, or even paralysis.
Although relatively rare, myelitis can affect people of all ages and can result from infections, autoimmune diseases, or other underlying health conditions. Because of its potential severity, early recognition and treatment are critical. In this article, we’ll explore the different types of myelitis, its symptoms, causes, diagnostic methods, treatments, and prevention strategies.
What is Myelitis?
Myelitis refers to inflammation of the spinal cord. Depending on the underlying cause and the specific part of the spinal cord that is affected, it may go by different names. For instance:
Transverse Myelitis – Inflammation that spans across both sides of the spinal cord.
Acute Disseminated Encephalomyelitis (ADEM) – A sudden, widespread attack of inflammation in the brain and spinal cord, usually following an infection.
Post-Infectious Myelitis – Occurs after a viral or bacterial infection.
Neuromyelitis Optica Spectrum Disorder (NMOSD) – An autoimmune condition that causes inflammation of the spinal cord and optic nerves.
All forms of myelitis interfere with normal nerve signal transmission, potentially causing long-term complications if untreated.
Types of Myelitis
Understanding the types of myelitis helps in identifying its root cause and planning treatment.
1. Transverse Myelitis (TM)
The most common type.
Causes damage across both sides of the spinal cord.
Often leads to weakness, numbness, and bowel/bladder dysfunction.
2. Acute Disseminated Encephalomyelitis (ADEM)
Usually follows a viral infection or, rarely, vaccination.
Involves widespread inflammation in the brain and spinal cord.
More common in children than adults.
3. Post-Infectious Myelitis
Occurs after an infection such as measles, mumps, or influenza.
Can develop days to weeks after the infection clears.
4. Neuromyelitis Optica Spectrum Disorder (NMOSD)
Autoimmune condition targeting the spinal cord and optic nerves.
Often mistaken for multiple sclerosis (MS), but requires different treatment.
5. Radiation-Induced Myelitis
Rare complication of radiation therapy for cancers near the spinal cord.
Causes of Myelitis
Myelitis can result from various underlying factors, including:
Infections
Viruses: Herpes simplex, varicella-zoster (chickenpox/shingles), HIV, influenza.
Bacteria: Tuberculosis, syphilis, Lyme disease.
Fungi and parasites in rare cases.
Autoimmune Disorders
Neuromyelitis optica.
Lupus and other connective tissue diseases.
Post-Infectious or Post-Vaccination Reactions
Abnormal immune response attacking the spinal cord.
Other Causes
Radiation therapy.
Certain cancers (paraneoplastic myelitis).
Vascular disorders reducing blood flow to the spinal cord.
Risk Factors
While myelitis can affect anyone, certain risk factors increase susceptibility:
History of viral or bacterial infections.
Autoimmune diseases (MS, lupus).
Weakened immune system (HIV, immunosuppressive drugs).
Recent vaccinations (very rare).
Family history of neurological disorders.
Symptoms of Myelitis
The symptoms of myelitis often develop suddenly over hours to days, but sometimes progress gradually. They depend on the part of the spinal cord affected and the severity of inflammation.
1. Motor Symptoms
Muscle weakness in arms or legs.
Difficulty walking or moving limbs.
Partial or complete paralysis in severe cases.
2. Sensory Symptoms
Numbness or tingling (pins-and-needles).
Loss of sensation to pain, temperature, or touch.
Heightened sensitivity to touch (allodynia).
3. Pain
Sharp or shooting pain radiating from the back down to arms or legs.
Severe lower back pain.
4. Autonomic Dysfunction
Loss of bladder control (urinary urgency, incontinence, or retention).
Bowel dysfunction (constipation or incontinence).
Sexual dysfunction.
Diagnosis of Myelitis
Since myelitis shares symptoms with other neurological conditions, a thorough diagnostic evaluation is crucial.
1. Medical History & Neurological Exam
Symptom onset, recent infections, vaccination history, autoimmune conditions.
Neurological assessment of muscle strength, reflexes, and sensation.
2. Magnetic Resonance Imaging (MRI)
Detects inflammation, swelling, or lesions in the spinal cord.
Helps rule out multiple sclerosis or tumors.
3. Lumbar Puncture (Spinal Tap)
Examines cerebrospinal fluid (CSF) for infection, antibodies, or immune markers.
4. Blood Tests
Detect infections, autoimmune markers, and vitamin deficiencies.
5. Evoked Potentials
Measures electrical activity in the brain and spinal cord to assess nerve function.
Treatment of Myelitis
Treatment depends on the underlying cause and aims to reduce inflammation, manage symptoms, and prevent long-term complications.
1. Medications
Corticosteroids: High-dose IV steroids to reduce inflammation.
Plasma Exchange (Plasmapheresis): Removes harmful antibodies from the blood.
Antiviral or Antibiotic Therapy: If an infection is identified.
Immunosuppressive Drugs: Used in autoimmune-related cases.
2. Symptom Management
Pain relievers and neuropathic pain medications.
Muscle relaxants for spasticity.
Bladder/bowel management strategies.
3. Rehabilitation Therapy
Physical therapy: Restores mobility and strength.
Occupational therapy: Helps with daily activities.
Psychological support: Managing stress, anxiety, and depression linked to chronic illness.
4. Long-Term Care
Some patients recover fully, while others experience lasting neurological deficits. Long-term management may include:
Assistive devices (canes, wheelchairs).
Regular follow-ups with neurologists.
Ongoing physiotherapy.
Complications of Myelitis
If untreated or severe, myelitis can lead to:
Chronic pain.
Sexual dysfunction.
Bladder and bowel incontinence.
Increased risk of recurrent episodes (especially in autoimmune cases).
Prognosis and Recovery
Recovery from myelitis is highly variable:
Some patients recover in weeks to months.
Others may have partial recovery with residual symptoms.
Severe cases may leave permanent disability.
Early intervention, intensive rehabilitation, and appropriate treatment improve the chances of recovery.
Prevention of Myelitis
While not always preventable, certain measures can reduce the risk:
Timely vaccination against infectious diseases.
Prompt treatment of infections (viral and bacterial).
Managing autoimmune conditions with regular medical care.
Strengthening immunity with healthy lifestyle habits.
Living with Myelitis
For those with long-term symptoms, lifestyle modifications and support are key:
Mobility aids for independence.
Pain management plans tailored by healthcare professionals.
Support groups and counseling for emotional well-being.
Regular follow-up care to monitor for relapses or complications.
Frequently Asked Questions (FAQ)
1. Is myelitis the same as multiple sclerosis (MS)?
No. While both involve inflammation of the nervous system, MS primarily affects the brain and spinal cord through multiple attacks, whereas myelitis is usually a single inflammatory episode.
2. How quickly does myelitis progress?
Symptoms often develop suddenly over hours to a few days, but in some cases, progression is gradual over weeks.
3. Can myelitis be cured?
There is no universal cure, but treatment can reduce inflammation, manage symptoms, and promote recovery. Some patients recover fully, while others may experience long-term effects.
4. Is myelitis life-threatening?
Most cases are not life-threatening with treatment. However, severe cases affecting breathing muscles or leading to paralysis require urgent medical attention.
5. Can myelitis recur?
Yes, particularly in autoimmune-related types such as neuromyelitis optica. Regular monitoring and preventive treatment may reduce recurrence risk.
6. Who should I see if I suspect myelitis?
You should consult a neurologist immediately if you develop sudden weakness, numbness, or bladder/bowel dysfunction.
Myelitis (spinal cord inflammation) is a serious neurological condition that requires prompt medical evaluation and treatment. While it may result from infections, autoimmune disorders, or post-infectious reactions, early recognition and therapy significantly improve recovery outcomes. With a combination of medical care, rehabilitation, and lifestyle support, many patients can regain independence and lead fulfilling lives.
If you or a loved one experience symptoms such as sudden weakness, numbness, or bladder problems, seek immediate medical attention to prevent complications.
To consult a Neurologist at Sparsh Diagnostic Centre, call our helpline number 9830117733.
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