Myelitis

What is myelitis?

Myelitis simply means inflammation of the spinal cord. It is not a disease in itself but a symptom of a range of conditions, so diagnosis of myelitis can be a complex process.

Myelitis is often referred to as transverse myelitis.

What are the symptoms of myelitis?

Depending on the location of the inflammation, myelitis can cause the following symptoms:

tingling in the legs or arms; loss of strength in the legs or arms; loss of sensation; back pain; pain in the lower back; problems with bladder or bowel control.

The symptoms might develop over a few hours or days, in other cases the onset may be several weeks or months.

How is myelitis diagnosed?

Diagnosing myelitis is complex, as the symptoms can be indicative of many other conditions. You will be asked about the nature of your symptoms and how long you have had them, and have a detailed neurological examination. 

Your doctor is then likely to refer you for tests, such as an MRI, a spinal tap, or blood tests, to consider conditions such as MS, neuromyelitis optica and infectious myelitis. 

What causes myelitis?

Myelitis can occur as a result of:

infections – including tuberculosis, syphilis, viral infections, and fungal infections autoimmune conditions – including multiple sclerosis, sarcoidosis and neuromyelitis optica.  multiple sclerosis

Polio is a form of myelitis caused by the poliovirus, but this disease has been almost eradicated through an effective vaccination programme.

In many cases of myelitis, the cause is unknown and you may be diagnosed with 'idiopathic myelitis'.

Can myelitis be prevented?

It’s possible to prevent some of the infections which can lead to myelitis, but for idiopathic myelitis there is no known prevention. If autoimmune myelitis is diagnosed, there are highly effective treatments to stop it recurring.  Myelitis affects people of all ages, and there is no specific risk factor which predisposes you to it.

How is myelitis treated?

Steroids can help to reduce inflammation in your spine and may be given as an initial treatment. If the doctor suspects you have a viral infection, they may give you antiviral medicine. If an autoimmune condition is suspected, other immunomodulatory treatments might be recommended. 

You may also be given medication to help with the symptoms, such as pain medicine.

If the damage from myelitis is long-term you might be offered physiotherapy and occupational therapy to help you improve your physical abilities or find alternative ways of carrying out daily tasks.

What type of specialist treats myelitis?

A neurologist specialises in the treatment of conditions affecting the spinal cord such as myelitis. In the long term you may also be treated by a physiotherapist or occupational therapist.