What are the presentation and treatment of Transverse Myelitis (TM)?

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Last updated: February 7, 2025View editorial policy

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From the Research

Presentation of Transverse Myelitis (TM)

  • Clinical presentation of TM typically includes some combination of motor weakness, sensory symptoms, and bowel and bladder dysfunction 1
  • Weakness, sensory disturbance, and autonomic dysfunction evolve over hours or days, most progressing to maximal clinical severity within 10 days of onset 2
  • At maximal clinical severity, half will have a paraparesis, and almost all patients have sensory disturbance and bladder dysfunction 2
  • Residual disability is divided equally between severe, moderate and minimal or none 2

Treatment of Transverse Myelitis (TM)

  • Acute therapeutic options for TM include corticosteroids, plasma exchange, IV immunoglobulin, and chemotherapeutic agents such as cyclophosphamide 1
  • In some instances, combinations of these therapies are used 1
  • Early aggressive treatment (usually with EV pulses of methylprednisolone and cyclophosphamide) might improve the prognosis 3
  • Cyclophosphamide and steroid therapy were the mainstay of the treatment once the TM had developed 4
  • Treatment outcomes were variable, depending mostly on the severity of the neurologic involvement at presentation, timing of the initiation of the therapy and patients adherence with the treatment 4

Etiology and Diagnosis of Transverse Myelitis (TM)

  • The causes of transverse myelitis are diverse; etiologies implicated include demyelinating conditions, collagen vascular disease, and parainfectious causes, however, despite extensive diagnostic work-up many cases are considered idiopathic 2
  • TM is also a rare complication of Behçet's disease (BD), an autoimmune process 4
  • TM associated with BD affected cervical and thoracic levels of the spinal cord 4
  • A major association was the history of panuveitis in all four cases of TM associated with BD 4

References

Research

MRI in transverse myelitis.

Journal of magnetic resonance imaging : JMRI, 2014

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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