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
- 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?
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?
- SCI from lesion and stenosis
- 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)
- PT, OT, Seating
What do Little Laura's therapy sessions include?
- locomotor training
- 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