-
What is the pathology of transverse myelitis?
- inflammation of the spinal cord that extends transversely across the cord
- myelin is destroyed impairing the nervous system
-
What is the etiology of transverse myelitis?
- definite cause unknown, but possible causes are viral infection, immune reaction, insufficient blood flow to cord, complication of other diseases
- 15-30% of cases are idiopathic
-
What is the epidemiology of transverse myelitis?
- no clear patterns in gender, race, geographic location, or family history
- 1.3-8 cases/per million
- peak onset 10-19 years, 30-39 years
-
What are signs and symptoms of transverse myelitis?
- loss of spinal cord function
- sudden onset of pain, weakness or sensory changes
- paralysis
- loss of bowel and bladder
- areas of weakness/sensory changes direectly correlate with level of cord damage
-
What is the most commonly affected level of the spinal cord in transverse myelitis?
thoracic level
-
What is the diagnostic criteria of transverse myelitis?
- bilateral (doesn't have to be symmetrical) sensorimotor and autonomic SC dysfunction
- clearly defined sensory level
- progression of defecits between 4 hours and 21 days of onset
- demonstration of SC inflammation
- exclusion of compressive, postradiation, neoplastic or vascular causes
-
What are some differential diagnosis of transverse myelitis?
- lupus
- MS
- SCI from lesion and stenosis
- sarcoidosis
- sjrogen's disease
-
What is the prognosis for someone with transverse myelitis?
- highly variable
- functional deficits can be permanent or fully recoverable once inflammation is controlled
- 50-70% return to ambulation
-
What are the different components of the medical management of transverse myelitis?
- corticosteroids to decrease inflammation acutely
- tone management
- B&B programs
- pain management
-
What are the different treatment methods of transverse myelitis?
- medical management
- prophylactic treatment (DVT, UTI)
- education
- PT, OT, Seating
-
What do Little Laura's therapy sessions include?
- locomotor training
- standing
- trunk strength and control
-
What is the progression of Little Laura's therapy?
- improved trunk control and sitting balance
- improved sensation in LEs
- improved bladder control/awareness
|
|
