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]
Gastrointestinal
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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. [merckmanuals.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]
A common problem in spinal cord injury is difficulty with evacuation of stool, although fecal incontinence can also occur. The neurologic pathways for defecation are similar to those of the bladder. [rarediseases.org]
Musculoskeletal
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Back Pain
These symptoms included bilateral lower extremity paresthesias, back pains in the thoracic and lumbar areas and pronounced lower extremity weakness. [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]
Remarkably, the patient reported only mild symptoms with severe back pain in the absence of profound signs of myelopathy. [karger.com]
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]
Urogenital
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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]
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. [merckmanuals.com]
A few hours after onset of limb weakness, he noticed urinary retention as well. He also developed constipation a day later. [casereports.in]
She required a urinary catheter for relief of urinary retention (1,000 to 1,500 cc) for two weeks, but at the end of this time she regained control of her bladder. She was able to return to home three weeks after admission. [kjim.org]
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Urinary Incontinence
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]
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]
Neurologic
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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]
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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]
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Hyperesthesia
Her course was characterized by paraplegia, sensory loss, hyperesthesia, and incontinence of urine and feces. All patients, except ours, recovered fully from ATM. [ncbi.nlm.nih.gov]
Forty-nine days after onset, thermal nociception and hyperesthesia had diminished (although incompatibility still existed) and bladder and rectal disturbance had recovered. Further, she was independent in defecation. [jaclinicalreports.springeropen.com]
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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]
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
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Human Parvovirus B19
We describe severe acute transverse myelitis in a previously healthy 9-year-old boy in whom primary human parvovirus B19 infection was confirmed serologically and B19 DNA was detected in his serum and cerebrospinal fluid. [ncbi.nlm.nih.gov]
parvovirus b19 infection. ( 24049056 ) Suzuki M....Tsutsumi H. 2014 48 Acute transverse myelitis complicating breakthrough varicella infection. ( 24853543 ) Aslan A....Gokben S. 2014 49 Acute transverse myelitis: a rare neurological complication following [malacards.org]
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Salmonella Typhi
Although, the association of Salmonella typhi infection and ATM is very rarely found in the literature, we believe this is the first report of ATM secondary to S. paratyphi B infection. [ncbi.nlm.nih.gov]
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]
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
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]
•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]
Pathophysiology NA Epidemiology The incidence of transverse myelitis in children varies both geographically and over time, however, not in a predictable fashion. [clinicaladvisor.com]
However, several factors can differentiate it from MS: 1) it typically involves different parts of the brain than in MS, 2) the severity of attacks can be more robust as compared to MS, and 3) the pathophysiology differs from MS – whereas MS is thought [myelitis.org]
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]