transverse myelitis.pdf detailed presentation on transverse myelitis

A brief description about the topic transverse myelitis
Introduction
Signs and symptoms
Pathophysiology
Causes
Treatment
Diagnosis
All are mentioned above in PPT

1. TRANSVERSEMYELITIS
Preeti Dubey
BPT FINAL YEAR

2. Content
1.Introduction
2.Etiology
3.Pathophysiology
4.Clinical features
5.Complications
6.Investigation
7.Treatment

3. Introduction
•Transverse myelitis is a segmental spinal cord injury caused by acute
inflammation.
•Transverse myelitis aka Acute Transverse Myelitis(ATM) is a rare
neurological disorder of the spinal cord, caused by inflammation and
occuring across one spinal segment, leading to severe motor, sensory
and autonomic dysfunction.
•This neurological disorders often damages the insulating material
covering nerve cell fibers(myelin).

4. Contd
•Transverse myelitis interrupts the messages that spinal cord nerves
send throughout the body.
•This cause pain, muscle weakness, paralysis, sensory problems, or
bladder and bowel dysfunction.

5. Etiology
•Exact reason for TM is not known. Sometimes there is no known
cause.
•Viral, bacterial and fungal infections affecting the spinal cord may
cause TM.
•Viruses associated with TM are:-
Herpes virus, cytomegalovirus, Epstein –Barr, HIV,
influenza, hepatitis B, mumps, measles and rubella.

6. Contd
•Bacterial infections associated with TM include:-
. Syphilis, tuberculosis, pertussis, tetanus, diptheria
•Bacterial skin infections gastroenteritis any certain types of
bacterial pneumonia also may cause TM.
•Rarely parasites and fungal infections may infect spinal
cord.

7. Contd
•There are number of inflammatory conditions that appear to cause
TM:-
. Multiple sclerosis
. Neuromyelitis optica
. Autoimmune disorders (lupus and sjogren’s syndrome)
. Vaccination
. Sarcoidosis

8. Pathophysiology
Three hypothesis have been proposed:-
1. Cell mediated autoimmune response
2. Autoimmune vasculitis
3. Direct viral invasion of spinal cord

9. Clinicalfeatures
•Features of spinal cord lesion:-
. Band like sensation (pressure, pain, numbness ) over trunk.
. Bladder symptoms ( incontinence, difficulty urinating, retention)
. Horizontal level of sensory loss
. U/L posterior column loss
. C/L Spinothalamic loss

10. Contd
•Typical presentation:-
. Prior history of fever
. Pain, paresthesia, radicular pain in the legs
. Weakness in arm or leg
. Abnormal sensation

11. Complication
1.Pain
2.Stiffness, tightness or painful spasm (In muscle)
3.Partial or total paralysis
4.Sexual dysfunction
5.Depression or anxiety

12. Investigation
1.MRI/CT Scan
2.Lumbar puncture
3.Blood test

13. Treatment
1.Medical Treatment
. Intravenous steroids ( methyl prednisolone/dexamethasone)
. Plasma exchange therapy
. Antiviral medication
. Pain medication (acetaminophen, ibuprofen)
. Medication to treat other complications spasticity, urinary or
bowel dysfunction,depression

14. Contd
. Medication to prevent recurrent attack of TM ( corticosteroid
and/or immunosuppressant.
2.Other therapy
. Physical therapy
. Occupational therapy
. Psychotherapy
. Vocational therapy