Transverse myelitis is a rare neurological condition caused by inflammation in the spinal cord. It can disrupt signals between the brain and body. This may affect movement, sensation, pain, balance, mobility, and bladder or bowel function.
For some people, symptoms develop suddenly over hours or days. For others, symptoms may progress more gradually over several weeks. Transverse myelitis can be frightening because symptoms may include weakness, numbness, difficulty walking, or even paralysis. Early evaluation by a neurologist is important because treatment may help reduce inflammation, identify the underlying cause, manage symptoms, and support recovery.
At South Miami Neurology, our team of 7 experienced neurologists provides comprehensive neurological care for patients throughout South Florida. If you or someone you love is experiencing new neurological symptoms, timely evaluation can help guide the next steps.
What Is Transverse Myelitis?
Transverse myelitis is an autoimmune and neuroinflammatory disorder. It occurs when a section of the spinal cord becomes inflamed. This inflammation may damage myelin, the protective covering around nerve fibers, and interfere with nerve signals traveling through the spinal cord.
The word “transverse” refers to symptoms that often occur across the body below the affected area of the spinal cord. Depending on where the inflammation occurs, symptoms may affect the legs, arms, torso, bladder, bowel, or a combination of areas.
Transverse myelitis can occur as a single episode, or it may be associated with another neurological or autoimmune condition, such as multiple sclerosis, neuromyelitis optica spectrum disorder, MOG antibody disease, or other inflammatory disorders. It may also occur after certain infections or, in some cases, without a clearly identified cause.
Symptoms of Transverse Myelitis
Symptoms can vary depending on the part of the spinal cord affected and how severe the inflammation is. Common symptoms may include:
• Back pain, neck pain, or pain that radiates into the arms, legs, chest, or abdomen
• Numbness, tingling, burning, cold sensations, or increased sensitivity to touch
• Weakness in the legs or arms
• Trouble walking, stumbling, heaviness in the legs, or dragging one foot
• Muscle spasms, stiffness, or tightness
• Balance problems
• Bladder symptoms, such as urgency, difficulty urinating, or incontinence
• Bowel dysfunction, including constipation or loss of control
• Sexual dysfunction
• Fatigue
• In severe cases, partial or complete paralysis
Some people describe a “band-like” tightness around the chest, abdomen, or back. Others may notice that symptoms affect both sides of the body, although one side can sometimes be more affected than the other. Any sudden weakness, numbness, trouble walking, or loss of bladder or bowel control should be treated as urgent and evaluated right away.
What Causes Transverse Myelitis?
Transverse myelitis may have several possible causes. In some cases, the immune system mistakenly attacks the spinal cord, causing inflammation. In other cases, inflammation may occur after an infection or as part of another disease process.
Possible causes and related conditions may include:
• Viral, bacterial, fungal, or other infections
• Parasites
• Multiple sclerosis
• Lyme disease
• MOG antibody-associated disease
• Autoimmune disorders
• Inflammatory disorders affecting the central nervous system
• Rare vascular or spinal cord conditions that may mimic transverse myelitis
Sometimes, no exact cause is found. This is known as idiopathic transverse myelitis. Because treatment and prognosis can differ depending on the cause, a thorough neurological evaluation is important.
How Is Transverse Myelitis Diagnosed?
A neurologist begins with a detailed medical history and neurological examination. The exam may assess strength, reflexes, sensation, coordination, walking, and bladder or bowel symptoms.
Diagnostic testing may include:
• MRI of the spine and sometimes the brain
• Blood tests to look for infection, autoimmune markers, or related inflammatory conditions
• Lumbar puncture, also called a spinal tap, to evaluate cerebrospinal fluid
• Additional testing for multiple sclerosis, neuromyelitis optica, MOG antibody disease, or other conditions
• Neurodiagnostic testing when appropriate
Diagnosis is important to confirm inflammation in the spinal cord. They also want to rule out other serious conditions that can look similar, such as spinal cord compression, spinal cord stroke, tumors, infections, or other causes of myelopathy.
Treatment for Transverse Myelitis
Treatment depends on the severity of symptoms and the suspected cause. Some patients may need hospital care, especially if symptoms are progressing quickly or affecting walking, bladder function, breathing, or overall safety.
Treatment may include:
• High-Dose Intravenous Steroids
Steroids are commonly used to reduce inflammation in the spinal cord, often over several days.
• Plasma Exchange Therapy
If symptoms are severe or do not respond well to steroids, plasma exchange may be considered. This treatment helps remove certain inflammatory factors from the blood.
• Treatment of Infection or Underlying Disease
If an infection, autoimmune disease, multiple sclerosis, neuromyelitis optica, or another condition is identified, treatment may be directed toward that cause.
• Pain and Symptom Management
Medications may help manage nerve pain, muscle spasms, stiffness, bladder symptoms, bowel symptoms, and other complications.
• Physical and Occupational Therapy
Rehabilitation can be an important part of recovery. Therapy may help improve strength, balance, mobility, coordination, independence, and safety with daily activities.
Recovery varies. Some people recover significantly, while others may have lasting symptoms. Early diagnosis, treatment, and rehabilitation can make a meaningful difference.
Transverse Myelitis Care at South Miami Neurology
South Miami Neurology provides comprehensive neurological care for patients with spinal cord, brain, nerve, and neuromuscular conditions. Our team includes 7 experienced neurologists who evaluate and treat a wide range of neurological concerns. Conditions may include weakness, numbness, walking difficulty, multiple sclerosis, Parkinson’s disease, epilepsy, migraines, stroke, dementia, and general neurological symptoms.
If symptoms suggest transverse myelitis or another spinal cord condition, a neurologist can help determine the appropriate evaluation and next steps. For a neurological evaluation, call South Miami Neurology at 305-665-6501.
Frequently Asked Questions About Transverse Myelitis
Is transverse myelitis serious?
Yes. Transverse myelitis can cause significant neurological symptoms, including weakness, numbness, pain, bladder problems, bowel problems, and difficulty walking. Sudden or worsening symptoms should be evaluated promptly.
Can transverse myelitis be treated?
Yes. Treatment may include high-dose steroids, plasma exchange, treatment of an underlying infection or immune disorder, medications for symptoms, and rehabilitation therapy.
Is transverse myelitis the same as multiple sclerosis?
No. Transverse myelitis is inflammation of the spinal cord. It can occur on its own, but it may sometimes be associated with multiple sclerosis or other inflammatory disorders. A neurologist can help determine the cause.
What are the first signs of transverse myelitis?
Early symptoms may include back pain, numbness, tingling, weakness, trouble walking, a tight band-like sensation around the torso, or bladder and bowel changes.
How is transverse myelitis diagnosed?
Diagnosis may involve a neurological exam, MRI, blood work, spinal fluid testing, and evaluation for infections, autoimmune conditions, multiple sclerosis, neuromyelitis optica, or MOG antibody disease.
Can people recover from transverse myelitis?
Many people recover at least partially, but recovery varies. Some patients have long-term symptoms and may need ongoing neurological care, therapy, and symptom management.
When should I see a neurologist?
Schedule an appointment if you have unexplained numbness, weakness, pain, balance problems, walking difficulty, or bladder or bowel changes. Seek urgent medical care for sudden weakness, paralysis, or loss of bladder or bowel control.
Sources:
Information in this article was reviewed using educational resources from the National Institute of Neurological Disorders and Stroke, Mayo Clinic, Cleveland Clinic, and Johns Hopkins Medicine.
References:
1. National Institute of Neurological Disorders and Stroke. “Transverse Myelitis.” National Institutes of Health. This source explains what transverse myelitis is, common symptoms, possible causes, diagnostic testing, treatment options, recovery, and rehabilitation.
2. Mayo Clinic. “Transverse Myelitis — Symptoms and Causes.” This source provides patient-friendly information on symptoms, causes, and when to seek medical care.
3. Cleveland Clinic. “Transverse Myelitis: Causes, Symptoms & Treatment.” This source reviews symptoms, diagnosis, treatment, and recovery outlook.
4. Johns Hopkins Medicine. “Transverse Myelitis.” This source provides an overview of transverse myelitis, including symptoms, causes, diagnosis, and treatment approaches.