Transverse myelitis is spinal cord inflammation causing damage to the covering of nerve cell fibers. It can occur by itself or as a symptom of an immune disease of the nervous system like MS.

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Keep reading to learn how transverse myelitis is linked with multiple sclerosis (MS) and its symptoms, causes, treatment, and more.

Transverse myelitis disrupts communication between nerve cells in the spinal cord and the rest of the body.

It typically inflames both sides of a spinal cord cross-section. Symptoms of transverse myelitis range from back pain to more serious problems, such as paralysis or loss of bowel control. Prompt diagnosis and treatment may help recovery.

Multiple sclerosis connection

Transverse myelitis is often a one-time illness. But for some people, transverse myelitis is an early symptom of another serious immune disease of the nervous system. One such disease is multiple sclerosis (MS).

MS is a chronic (long-term) disease with no cure. It occurs when the body’s immune system attacks the protective coating of myelin around nerves in the brain, optic nerves, and spinal cord. It can limit mobility and cause pain.

MS can affect various parts of your body, including your:

  • brain
  • eyes
  • arms and legs

The severity of symptoms varies from person to person.

Partial myelitis

Partial myelitis, which affects only one side of the cross-section, is more commonly a symptom of MS.

The National Institute of Neurological Disorders and Stroke recommends that anyone with transverse myelitis or partial myelitis gets checked for MS.

MS and transverse myelitis share some common symptoms, such as a tingling sensation in the arms and legs.

There are also some significant differences between MS and transverse myelitis:

Transverse myelitis symptoms

People with transverse myelitis often experience back pain as their first symptom. Extreme sensitivity to touch, known as allodynia, is also present in about 80 percent of people with transverse myelitis, according to the National Multiple Sclerosis Society.

Symptoms of transverse myelitis can include:

  • back pain
  • sensitivity to touch
  • motor issues, like muscle limpness or tightness
  • a burning or aching feeling or a pins-and-needles feeling
  • weakness in the arms and legs
  • bladder and bowel dysfunction, including incontinence, urgency, and constipation

Depending on the location of inflammation in the spinal cord, different parts of the body may be affected.

MS symptoms

MS symptoms usually include:

  • numbness or weakness in the limbs
  • vision problems
  • dizziness
  • loss of coordination
  • bladder dysfunction
  • pain and spasms

The causes of transverse myelitis aren’t completely understood. The National Institute of Neurological Disorders and Stroke suggests that the disease may be caused by an infection or by the body’s immune response to an infection.

Causes of transverse myelitis can include:

  • Immune system disorders. Disorders like MS and neuromyelitis optica may play a role in causing inflammation and damage to the spinal cord.
  • Immune response. The body’s immune response to infection and vaccines may cause this condition.
  • Viral infection. Viruses that cause the Zika virus, the West Nile virus, influenza, hepatitis B, chickenpox and shingles, measles, mumps, rubella, and possibly COVID-19, among others, may cause transverse myelitis.
  • Bacterial infection. Infections including syphilis, tuberculosis, Lyme disease, and middle ear infections may also cause transverse myelitis.
  • Fungal infections. Fungal infections in the spinal cord may cause this condition.
  • Parasites. Parasites like toxoplasmosis, which is found in contaminated water and uncooked meat, may cause transverse myelitis.
  • Other inflammatory disorders. Transverse myelitis is associated with systemic autoimmune inflammatory disorders like rheumatoid arthritis and systemic lupus erythematosus.
  • Vascular disorders. Conditions including arteriovenous malformations (AVMs) may cause transverse myelitis.

When it occurs due to another disease or condition, it may be called secondary transverse myelitis. MS may eventually develop in 10 to 33 percent of cases of acute partial transverse myelitis.

Transverse myelitis can occur in people of all ages and races. In addition, transverse myelitis tends to appear in younger people. It occurs most frequently between the ages of 10 and 19 and between the ages of 30 and 39.

When associated with MS, it affects more women than men.

A doctor usually orders a magnetic resonance imaging (MRI) scan to diagnose transverse myelitis. An MRI of your spinal cord will show if there is inflammation. This will help the doctor determine whether your pain is from a slipped disc or another condition like MS.

Tests the doctor might perform include:

The doctor may ask for your medical and family history. A neurological exam is also required to diagnose transverse myelitis and MS.

Treatment for transverse myelitis often begins with drugs called corticosteroids to decrease inflammation. You may also receive medication for pain and antiviral medication if your case of transverse myelitis is caused by a viral infection.

Since moving your limbs is important to help keep them healthy, you will also likely receive physical therapy to help repair nerve damage. You may also receive occupational therapy to help build independence in certain tasks.

Other treatments may include:

  • plasma exchange therapy, if steroids do not work
  • immunoglobulin, an injection of antibodies from healthy people to help reset your immune system
  • medications to treat other conditions caused by transverse myelitis

Waiting to get treatment is dangerous. The sooner you are treated after symptoms appear, the better your chance of recovery. In some cases, you may begin treatment before all of your test results are back.

Most people who get transverse myelitis spontaneously, such as from a viral infection, make at least a partial recovery. This may take about 1 to 3 months. Their condition may continue to improve after physical therapy, which can take up to 2 years. Most recovery tends to take place within 3 months from the beginning of transverse myelitis symptoms.

For around 40 percent of people with transverse myelitis, some symptoms may not go away. This might include urinary urgency or weakness.

About one-third of people with transverse myelitis may continue to experience symptoms of paralysis and incontinence after recovery. This may be more likely to occur in severe, quickly progressing cases.

For those with a chronic disease like MS, transverse myelitis may occur again, and treatment may include medications to prevent it from recurring.

Transverse myelitis is a serious condition in which inflammation occurs in the spinal cord, causing pain, weakness, and incontinence. While rare, it can occur due to an infection, an immune system response, or an immune system disorder like MS.

Prompt treatment may lead to a better chance of recovery, so it is important to seek medical attention if you believe you or someone you know may have transverse myelitis.