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Acute Transverse Myelitis

Inflammatory disorder of the spinal cord

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Nöroloji department. Book Appointment →

What is Acute Transverse Myelitis?

Acute transverse myelitis is characterized by spinal cord inflammation producing motor, sensory, and autonomic deficits with rapid progression over hours to days.

Causes include multiple sclerosis, neuromyelitis optica spectrum disorder (NMOSD), MOG antibody disease, infections (varicella zoster, Mycoplasma), and post-infectious or post-vaccination immune-mediated disease.

Diagnosis combines clinical features, MRI showing T2 hyperintense lesions extending one or more vertebral segments, CSF analysis (pleocytosis, oligoclonal bands), and serologies (AQP4, MOG antibodies).

Distinguishing transverse myelitis from compressive lesions, vascular events, and metabolic causes is critical for appropriate therapy.

Symptoms

Acute or subacute weakness in legs (paraparesis) or all four limbs
Sensory level with numbness or loss of sensation below the lesion
Bowel and bladder dysfunction (urinary retention or incontinence)
Sexual dysfunction in adults
Back pain at the level of the lesion (often the initial symptom)
Spasticity and hyperreflexia developing over days

Risk Factors

Recent viral illness or vaccination
Underlying multiple sclerosis or neuromyelitis optica
Connective tissue disease (lupus, Sjogren syndrome)
MOG antibody disease and other autoimmune disorders
Recent COVID-19 infection
Pediatric age group can present with parainfectious myelitis

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Acute onset weakness, especially in both legs
  • Numbness with a clear sensory level on the trunk
  • New onset urinary retention or incontinence
  • Severe back pain with neurologic symptoms
  • Rapid progression of symptoms over hours to days
  • Recent infection followed by neurologic deficits

Treatment Methods

01
High-dose intravenous methylprednisolone (1 g/day for 3-7 days) as first-line treatment
02
Plasma exchange (5-7 sessions) for severe or steroid-refractory cases
03
IVIG in selected cases or as alternative to plasma exchange
04
Treatment of underlying cause (rituximab for NMOSD, disease-modifying therapy for MS)
05
Acyclovir or appropriate antimicrobial therapy if infection is identified
06
Long-term rehabilitation with physical, occupational, and bladder therapy

Which Department to Visit?

You can visit our Nöroloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.