Myelitis

Myelitis has been commonly correlated with virus infected respiratory tracts and gastrointestinal tracts.

Causes

The exact cause for most cases are unknown. However, there are a number of conditions, which seem to cause the illness. These include:

Viral Infections: Viruses that directly infect the spinal cord is herpes, chickenpox, shingles and West Nile virus. In some rare cases, bacteria like Lyme disease causes painful inflammation of spinal cord roots.

Multiple Sclerosis: In this disorder, the immune system destroys the nerves surrounding the myelin in the spinal cord and brain.  

Neuromyelitis Optics: Or Devic’s disease is a condition in which there is inflammation or loss of myelin around the spinal cord or eye nerve that transmits information to the brain.

Vaccinations: For diseases like Hepatitis B, Diphtheria-Tetanus and Measles – Mumps – Rubella are occasionally seen as a trigger of Myelitis.

Symptoms

The symptoms generally develop over few hours and worsen over a few days. Typical symptoms include pain (neck or back area), sharp sensations down the legs or arms, numbness, coldness, tingling, burning, extra sensitive to touch, extreme cold or extreme heat, weakness in arms or legs, increased urinary urge, painful urinating and constipation. 

Tests

The tests undertaken to diagnose Myelitis include Magnetic Resonance Imaging (MRI) to view cross-sectional or 3D images of the soft tissues of the inflamed spinal cord and blood vessel malformations. The Lumbar Puncture is carried out to draw out cerebrospinal fluid (fluid surrounding spinal cord and brain). People affected with myelitis have abnormally high levels of white blood cells in the fluid. A series of blood tests to check for antibodies associated with neuromyelitis optica are carried out. Many other blood tests are also undertaken depending upon the case to rule out other causes of the symptoms.

Treatment

Several different treatments are undertaken to target the myelitis symptoms. These include Intravenous Steroids (through arm veins to reduce inflammation), Plasma Exchange Therapy (includes removal of blood cell fluid from the plasma and replacement with special fluids), Anti-Viral Medication and Pain Medication (including acetaminophen, ibuprofen and naproxen sodium). Nerve pain may be treated with anti-depressant drugs like sertraline, gabapentin or pregabalin. Other medications for treatment of problems like urinary dysfunction, bowel dysfunction, depression or muscle spasticity are prescribed by the doctor. The non-drug therapies for long-term recovery include physical therapy (to increase strength and improve coordination), occupational therapy (new ways to perform day-to-day activities) and psychotherapy.

Prognosis

Recovery generally begins within 2 to 12 weeks and in some cases can take up to 2 years. If there is no improvement in the first couple of months, complete recovery is unlikely. Majority of patients only experience one episode of re-current or re-lapse of the disease. While some recover completely and then experience a relapse, others begin to recover and then suffer worsening of symptoms before recovery continues again. 

Prevention

A major number of myelitis cases can be prevented if respiratory tract infections can be avoided. This can happen by undertaking influenza vaccines.

Treatment Cost

Since each case is different, the related treatment cost varies from case to case. The treatment costs are high and relatively ongoing as it can take many years for complete recovery. The treatment cost includes medical practitioner fees, medications, testing fee and therapy fee.