From the Research
Transverse myelitis (TM) can be both genetic and sporadic, with most cases being sporadic and triggered by post-infectious immune responses, autoimmune disorders, or inflammatory processes, as supported by the most recent study 1. The pathophysiology of TM typically involves inflammation of the spinal cord leading to demyelination and neuronal damage, regardless of whether the cause is genetic or sporadic. Some key points to consider in the diagnosis and management of TM include:
- The importance of determining the disease-specific diagnosis of TM, as management and prognosis differ for each specific etiology 1
- The role of immune-mediated causes, such as multiple sclerosis, aquaporin-4-IgG-positive neuromyelitis optica spectrum disorder (AQP4+NMOSD), and myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) 1
- The use of disease-associated antibodies, such as aquaporin-4, to guide diagnosis and treatment 2
- The potential for genetic components in some cases of TM, particularly when they occur as part of broader genetic disorders that affect the nervous system or immune function 2 Understanding the specific etiology in each case is crucial for appropriate management, as treatment approaches may differ depending on whether the condition is part of a genetic syndrome or an isolated inflammatory event. The most recent study 1 provides the most up-to-date information on the diagnosis and management of TM, and should be prioritized in clinical decision-making. Some of the key takeaways from this study include:
- The importance of aggressive treatment approaches to improve patient outcomes
- The use of targeted therapy with monoclonal antibodies to provide new treatment options for patients
- The need for further research to provide solid evidence for treatment efficacy in certain etiologies of TM.