From the Guidelines
Transverse myelitis is typically treated by a multidisciplinary team led by neurologists who specialize in inflammatory disorders of the central nervous system. This team may include rehabilitation physicians, physical therapists, occupational therapists, and urologists, among others, to provide comprehensive care 1. The treatment approach is highly individualized and depends on the severity and cause of the condition.
Treatment Approach
The treatment generally begins with high-dose intravenous corticosteroids, followed by an oral prednisone taper, and in severe cases, plasma exchange therapy may be used 1. For cases associated with autoimmune conditions, immunosuppressive medications might be prescribed. Pain management is also a crucial aspect of treatment and often involves medications such as gabapentin, pregabalin, or amitriptyline.
Multidisciplinary Care
Adequate management of complications is best undertaken by a multidisciplinary team, which might include nurses, physiotherapists, rehabilitation specialists, occupational therapists, speech therapists, and dietitians 1. This team approach ensures that all aspects of the patient's care are addressed, from physical rehabilitation to psychological support.
Key Considerations
It is essential to recognize that patients with conditions like transverse myelitis, even those with significant paralysis, usually have intact consciousness, vision, and hearing 1. Therefore, caregivers should be mindful of what is said at the bedside and explain the nature of procedures to patients to reduce anxiety. A multidisciplinary team led by a neurologist is best equipped to provide the comprehensive care needed for patients with transverse myelitis, addressing both the physical and psychological aspects of the condition.
From the Research
Treatment of Transverse Myelitis
The treatment of transverse myelitis typically involves a multidisciplinary approach, with various healthcare professionals playing a role in the management of the condition. Some of the key healthcare professionals involved in the treatment of transverse myelitis include:
- Neurologists: who specialize in the diagnosis and treatment of neurological disorders, including transverse myelitis 2, 3, 4, 5
- Immunologists: who may be involved in the treatment of transverse myelitis, particularly in cases where the condition is caused by an autoimmune disorder 4, 5
- Rheumatologists: who may be involved in the treatment of transverse myelitis, particularly in cases where the condition is caused by a systemic autoimmune disorder such as systemic lupus erythematosus 4, 5
- Physical medicine and rehabilitation specialists: who may be involved in the rehabilitation of patients with transverse myelitis, particularly in cases where the condition has resulted in significant disability 2, 5
Management of Transverse Myelitis
The management of transverse myelitis typically involves a combination of medications, therapies, and lifestyle modifications. Some of the key management strategies for transverse myelitis include:
- Corticosteroids: which may be used to reduce inflammation and swelling in the spinal cord 3, 6
- Plasma exchange: which may be used to remove antibodies and other immune factors that may be contributing to the condition 3
- Cyclophosphamide: which may be used to suppress the immune system and reduce inflammation in the spinal cord 3
- Rehabilitation therapies: such as physical therapy, occupational therapy, and speech therapy, which may be used to help patients regain functional abilities and independence 2, 5