Presentation
Fever, paraparesis, quadri-paresis and bladder dysfunction were the most common presentations. Median score on disability rating scale (DRS) was twelve. [ncbi.nlm.nih.gov]
Entire Body System
- Pain
We report the efficacy of SCS for relief of severe neuropathic pain in both lower limbs secondary to IATM, which had failed to respond to conventional pain therapies. [ncbi.nlm.nih.gov]
We report a 31-year-old man who complained of back pain and claudication of both lower extremities. The patient showed typical inflammatory back pain and significant sacroiliitis, consistent with AS. [ekjm.org]
Textbook descriptions of ATM mention pain in the back or extremities and sensory loss as the earliest symptoms. [pediatricneurologybriefs.com]
- Disability
The presence of this antibody in acute transverse myelitis (ATM) has been associated with recurrence and conversion to NMO, but the influence on disability has not yet been described. [ncbi.nlm.nih.gov]
- Severe Pain
Severe pain suggests worse inflammation. The outcome is split evenly: About one third of people recover. About one third continue to have some muscle weakness and urinary problems (urgency or loss of bladder control). [msdmanuals.com]
Respiratoric
- Pneumonia
Medical history is significant for pneumonia caused by Mycoplasma pneumoniae. He denies weight loss, night sweats, or recent vaccinations. Physical exam is notable for bilateral lower extremity sensory deficits and motor weakness. [medbullets.com]
This disorder may result from a variety of causes, such as multiple sclerosis, measles, pneumonia, viral infections, and the ingestion of certain toxic agents such as carbon monoxide, lead, and arsenic. [medical-dictionary.thefreedictionary.com]
Blood culture was highlighted Klebsiella pneumoniae. The cytobacteriological examination had highlighted Escherichia coli. Analysis of the cerebrospinal fluid (CSF) showed elevated protein but no germ was isolated in the LCS. [article.sciencepublishinggroup.com]
Bacterial skin infections, middle-ear infections, and bacterial pneumonia have also been linked with TM. Some experts believe that infection causes a derangement of the immune system, which leads to an indirect autoimmune attack on the spinal cord. [christopherreeve.org]
He uses this to describe a case of rapidly progressive paraparesis with a thoracic sensory level, occurring as a post-infectious complication of pneumonia In the MRI scan opposite, the TM lesion is the lighter, oval shape at center-right. [physio-pedia.com]
Gastrointestinal
- Fecal Incontinence
Deficits may progress over several more days to a complete transverse sensorimotor myelopathy, causing paraplegia, loss of sensation below the lesion, urinary retention, and fecal incontinence. [msdmanuals.com]
On day 3, she developed retention of urine, fecal incontinence, and loss of sensation below neck level with sign of respiratory distress. She was given ventilatory support. [atmph.org]
Autonomic dysfunction was defined as “positive” when the patient had medical record documentation of urinary urgency, urinary incontinence, fecal incontinence, tenesmus, or sexual dysfunction. [ceemjournal.org]
- Diarrhea
In early April, he complained of fever, abdominal pain, and diarrhea without blood or mucus, all of which resolved without therapy. He became ill again on April 26, with fever, chills, sweats, anorexia, mild nonbloody diarrhea, and abdominal pain. [cdc.gov]
Lyme disease gives rise to neuroborreliosis which is seen in a small percentage (4 to 5 per cent) of acute transverse myelitis cases. [10] The diarrhea-causing bacteria Campylobacter jejuni is also a reported cause of transverse myelitis. [11] Other associated [en.wikipedia.org]
(Brazil) [12] Case Report M / 58 years old Fever, weakness, malaise, headaches, diarrhea, itchy macular cutaneous eruption in lower limbs, petechiae, myalgia, anorexia. [omicsonline.org]
Cardiovascular
- Thrombosis
We report on a total of 70 patients. aPL, detected upon ATM onset in 54% of patients, neither predicted the involvement of the thoracic part of the spine, which has been postulated to reflect a predominantly thrombosis-induced injury, nor correlated with [ncbi.nlm.nih.gov]
Exclusion criteria include : prior spinal irradiation; anterior spinal artery thrombosis; AV malformation; connective tissue disease (sarcoidosis, Behcet’s, SLE etc); CNS syphilis, Lyme disease, HIV, HSV, EBV, CMV, or other viral disease; MRI evidence [pediatricneurologybriefs.com]
Venous thrombosis in multiple sclerosis patients after high-dose intravenous methylprednisolone: the preventive effect of enoxaparin. Thrombosis. 2011;2011:785459. [jaclinicalreports.springeropen.com]
Our patient also had a big left leg before being hospitalized in our service then objectified thrombosis in venous Doppler ultrasound of the left leg. [article.sciencepublishinggroup.com]
[…] pleocytosis or increased IgG index or gadolinium enhancement progression to nadir between 4 hours and 21 days after the onset of symptoms exclusion criteria radiation to the spine within the last 10 years arterial distribution clinical deficit consistent with thrombosis [radiopaedia.org]
- Hypertension
It can be source of thrust hypertension, which can be a source of cardiovascular and neurological injury or even death [ 9 ]. [article.sciencepublishinggroup.com]
Physical Examination • Extreme irritability • extent of weakness is assessed by how vigorously the child resists examination • Fever, hypertension, tachycardia, meningeal signs may be present, in which cases CNS infection need to be ruled out; • point [slideshare.net]
Cord ischemia due to venous hypertension or arterial steal can be seen in vascular malformations like AV-fistula. So always look for abnormal vessels around the cord. Infammatory Vasculitis Infection Infection rarely involves the spinal cord. [radiologyassistant.nl]
Hipointensiva lesion in the T1 sequence and a hypertensive signal in T2 sequence between T7-T9. Dengue IgM/IgG: + / -, Negative for HIV, CMV, HSV, HTLV-I IgG oligoclonal band. Post-infection (15 days 10 days). [omicsonline.org]
Hypertension, hypercholesterolemia, diabetes mellitus, smoking habit, traumatic events, and symptoms related to infection (eg, flu, gastrointestinal, or urinary tract symptoms) within one month before the onset of IATM symptoms were also collected. [bmcneurol.biomedcentral.com]
Musculoskeletal
- Back Pain
We report a 31-year-old man who complained of back pain and claudication of both lower extremities. The patient showed typical inflammatory back pain and significant sacroiliitis, consistent with AS. [ekjm.org]
These symptoms included bilateral lower extremity paresthesias, back pains in the thoracic and lumbar areas and pronounced lower extremity weakness. [ncbi.nlm.nih.gov]
Remarkably, the patient reported only mild symptoms with severe back pain in the absence of profound signs of myelopathy. [karger.com]
Symptoms range from back pain to more serious problems, such as paralysis or loss of bowel control. Multiple sclerosis connection Transverse myelitis is often a onetime illness. [healthline.com]
Neurologic
- Paresthesia
These symptoms included bilateral lower extremity paresthesias, back pains in the thoracic and lumbar areas and pronounced lower extremity weakness. [ncbi.nlm.nih.gov]
The clinical manifestations common to both forms include motor involvement (limb weakness, stiffness and muscle spasms with impaired respiratory function in cases with involvement of the upper spinal cord), sensory manifestations (back pain, paresthesia [orpha.net]
Approximately 90 days after transplantation, she suffered from paresthesias, sphincter dysfunction, and lower extremity weakness. Spinal cord magnetic resonance imaging scan demonstrated findings consistent with ATM. [dear-medic.jp]
There was a single case of permanent paresthesia of the lower limbs after six months [ 10 ] and one case of moderate weakness in the lower limbs after six months [ 11 ]. [omicsonline.org]
- Tingling
tingling sensation in the legs - rapidly evolving relatively symmetrical ascending weakness or flaccid paralysis - pain What are the phases of GB? 1. Progression phase- constant deterioration of function, 1-4 weeks 2. [quizlet.com]
A bandlike tightness around the chest or abdomen, weakness, tingling, numbness of the feet and legs, and difficulty voiding develop over hours to a few days. [msdmanuals.com]
Damage to the spinal cord can result in symptoms such as paralysis, pain, loss of bowel and bladder control, sensory changes such as numbness or tingling in the limbs, and muscle weakness. [mobilitymgmt.com]
- Unable to Walk
Eighty-nine percent were unable to walk, required assisted ventilation, or both. [ncbi.nlm.nih.gov]
Only 9.4% of patients with IATM were unable to walk unassisted at the end of follow-up. [bmcneurol.biomedcentral.com]
Approximately 50% of patients with this condition are unable to walk upon reaching their maximum level of disability, 3 and a third recover poorly and remain severely disabled. 4 In 2002, the Transverse Myelitis Consortium Working Group (TMCWG) proposed [elsevier.es]
- Hyperreflexia
Flaccid weakness gradually changes to pyramidal tract signs, with hyperreflexia, clonus, and extensor responses. A sensory level (between T5-T10) affects primarily pain and temperature, and posterior columns are usually spared. [pediatricneurologybriefs.com]
Neurological Examination: severe reduction of visual acuity in the right eye with papilledema, paraparesis (stage 4), hyperreflexia and signs of bilateral Babinski. [omicsonline.org]
Clinical presentation Typical presentation • Prior history of fever (nonspecific viral illness) • ATM, the onset of spinal cord dysfunction usually progress in 4 hours to 21 days, the patient's signs usually plateau and evolve toward spasticity/hyperreflexia [slideshare.net]
Sx: leg weakness, sphincter dysfunction, abnormal DTRs [acutely may be absent, but hyperreflexia the rule]. Sensory level helps distinguish from polio/Guillain-Barre (GB). [hopkinsguides.com]
- Pyramidal Tract Signs
Flaccid weakness gradually changes to pyramidal tract signs, with hyperreflexia, clonus, and extensor responses. A sensory level (between T5-T10) affects primarily pain and temperature, and posterior columns are usually spared. [pediatricneurologybriefs.com]
Urogenital
- Urinary Retention
We describe a 40-year-old man who presented with an acute onset quadriparesis with urinary retention, which was preceded by fever and headache 3 weeks prior. He had elevated IgM titres against JE virus in serum and cerebrospinal fluid. [ncbi.nlm.nih.gov]
Acute urinary Retention, paraplegia, hypoesthesia. [omicsonline.org]
Physical therapy may also be helpful to retrain muscles necessary for improved bladder and bowel control and relief of constipation and urinary retention. [encyclopedia.com]
A few hours after onset of limb weakness, he noticed urinary retention as well. He also developed constipation a day later. [casereports.in]
Deficits may progress over several more days to a complete transverse sensorimotor myelopathy, causing paraplegia, loss of sensation below the lesion, urinary retention, and fecal incontinence. [msdmanuals.com]
- Urinary Incontinence
Bladder and bowel problems.These problems may include an increased urinary urge, urinary incontinence, difficulty urinating and constipation. Prognosis of TM Generally, prognosis for complete recovery from TM is not good. [mytm.ca]
Autonomic dysfunction was defined as “positive” when the patient had medical record documentation of urinary urgency, urinary incontinence, fecal incontinence, tenesmus, or sexual dysfunction. [ceemjournal.org]
Bladder dysfunction is an integral part in majority and could be the presenting symptom of transverse myelitis. [12] Its management is important to prevent recurrent urinary tract infection, preserve renal function, and manage urinary incontinence. [18 [ruralneuropractice.com]
Weakness in the lower limbs, paraplegia and urinary incontinence. Neurological Examination: spastic paraplegia, Babinski sign bilateral patellar, hyperreflexia and aquiliana, sensorial level T4. Hyperintense Signal on T2 sequence between T2-T10. [omicsonline.org]
Workup
We evaluated the spectrum clinical features and paraclinical findings encountered during diagnostic workup and aiding the diagnosis. SETTING: Department of Neurology, Inselspital Bern, Switzerland. [ncbi.nlm.nih.gov]
Workup for the underlying cause was carried out, including serology for human immunodeficiency virus (HIV). [casereports.in]
Microbiology
- Bartonella Henselae
Cat scratch disease (CSD) is a benign, self-limiting condition associated with Bartonella henselae. Neurological manifestations are uncommon. Acute transverse myelitis and Guillain-Barré syndrome have been reported rarely with CSD. [ncbi.nlm.nih.gov]
Co-existence of acute transverse myelitis and Guillain-Barre syndrome associated with Bartonella henselae infection. Acute transverse myelitis and Guillain-Barre overlap syndrome with serological evidence for mumps viraemia. [freethesaurus.com]
Transverse myelitis in 2 patients with Bartonella henselae infection (cat scratch disease). Clin Infect Dis. 2007;45(4):e42-5. [PMID:17638185] Comment: Cases described in an adolescent and a 46-year old adult. [hopkinsguides.com]
The common bacterial infectious causes are Mycoplasma pneumoniae, Lyme disease, and cat scratch fever (Bartonella henselae). Viral infections include HSV, herpes zoster, CMV, EBV, and HIV. [emdocs.net]
Transverse myelitis in 2 patients with Bartonella henselae infection (cat scratch disease). Clin Infect Dis 2007 ; 15 : 42 –45. 51. Hmaimess G, Kadhim H, Saint Martin C, Abu Serieh B, Mousny M, Sébire G. [cambridge.org]
Treatment
There is scarce observational data and a lack of randomised controlled studies regarding the treatment of Sjoegren's syndrome in the presence of such complications. [ncbi.nlm.nih.gov]
Prognosis
Prognosis depends on a number of factors, and evidence suggests that the majority of children have a good outcome. [ncbi.nlm.nih.gov]
History Meanings of "prognosis of acute transverse myelitis" in Turkish English Dictionary : 1 result(s) Category English Turkish Medical 1 Medical prognosis of acute transverse myelitis akut transvers miyelit prognozu Pronunciation of prognosis of acute [tureng.com]
Etiology
Therefore, the identification of clinical and paraclinical features providing clues of the underlying etiologies is needed. [ncbi.nlm.nih.gov]
Epidemiology
A controlled multicenter study is suggested to assess epidemiology, etiology and prognosis of ATM. [ncbi.nlm.nih.gov]
Pathophysiology
Provides in-depth coverage of CSF examination and analysis, CSF physiology and pathophysiology, approach to diagnosis, and future directions in CSF analysis. [books.google.de]
The significance of these findings and the possible role antiganglioside antibodies may play in acute transverse myelitis pathophysiology is discussed. [ncbi.nlm.nih.gov]
The pathophysiology of ATM consists primarily of inflammatory disorders, similar to the neurological complications of AS. We suggest that ATM is a possible extra-articular manifestation of AS. [ekjm.org]
The Johns Hopkins Transverse Myelitis Center is dedicated to the diagnosis and treatment of acute transverse myelitis (TM) and to better understanding the pathophysiology of the disease. [hopkinsmedicine.org]
•Postinfectious etiology largely predominates in children. 11. pathophysiology •Three hypotheses have been proposed: 1. Cell mediated autoimmune response 2. autoimmune vasculitis 3. direct viral invasion of spinal cord. 12. [slideshare.net]
Prevention
Our report emphasizes that the Varicella zoster virus booster vaccine may be necessary to prevent not only acute varicella, but also its postinfectious neurologic complications. [ncbi.nlm.nih.gov]
SATM is often relapsing and prognosis depends on prevention of further episodes. The documents contained in this web site are presented for information purposes only. [orpha.net]