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Transverse Myelitis Treatment




Transverse Myelitis Treatment

There is currently no effective cure for transverse myelitis, and very few experimental treatments in the news.

However, there are many different treatments that are offered to patients with transverse myelitis:

  • treating any underlying cause (if known).
  • halting the progression of the damage to the spinal cord
  • learning to cope with the physical and psychological issues that result from living with new limitations and challenges.

Most transverse myelitis treatment aims to manage and alleviate symptoms of the disorder. The symptoms that result from transverse myelitis are generally neurological in nature, such as nerve pain.

In addition to pain and physical disabilities, patients must learn to cope with the psychological and emotional impact of living with new limitations and challenges. In some cases, patients require treatment and counseling for depression.

Most experts agree that treatment for transverse myelitis should generally begin as soon as possible.

Which transverse myelitis treatments are used at the initial onset?

The initial transverse myelitis treatment can depend on a number of factors such as symptoms, test results, progression, etc.

In idiopathic cases of transverse myelitis, a high-dose of intravenous corticosteroids are often administered. Sometimes, the treatment is followed by plasma exchange therapy. The effectiveness of both treatments is uncertain.

In almost all cases, bed rest is often highly recommended during the initial days and weeks after onset of the disorder.

Below are some common initial transverse myelitis treatments:

  • Intravenous steroids (corticosteroid medications): This treatment is believed to help reduce the inflammation in the spinal column.
  • Plasma exchange therapy: This treatment is believed to remove antibodies that are involved in the inflammation.
  • Pain Management: This treatment aims to provide comfort to the patient.
  • Other Treatments: There are additional treatments that have been prescribed for transverse myelitis patients.

CORTICOSTEROID MEDICATIONS

Physicians often prescribe a high dose of intravenous steroids immediately following the onset of symptoms or diagnosis. These medications can include those such as methylprednisolone or dexamethasone.

Corticosteroid medications are believed to work by reducing the activity of the immune system to prevent the immune system from attacking the myelin of the spinal cord. Of course, this treatment would only be selected by physicians who believe that transverse myelitis is partially or fully autoimmune in nature. Clinical studies are few, or non-existent, in the investigation of the impact that corticosteroid medications have on the course of transverse myelitis. No studies have provided evidence that this treatment is effective.

After administering this treatment, it is believed by some that about half the people with transverse myelitis will recover within six months. This method is generally administered for patients with acute transverse myelitis.

Intravenous steroids are usually prescribed for between three to five days. The patient is often prescribed oral corticosteroid medications to taper the patient off the high dosage. Some patients are prescribed oral corticosteroid medications for longer periods of time. However, the decision to continue steroid medications or to add a new treatment is usually dependent on the MRI results at the end of the high dosage corticosteroid treatment.

PLASMA EXCHANGE THERAPY

Plasma exchange therapy has shown some positive results for transverse myelitis patients.

Plasma exchange therapy is generally chosen for those with moderate to severe TM who don’t show much improvement after being treated with intravenous steroids.

PAIN MANAGEMENT

One of the first symptoms reported by patients is pain. The initial pain management generally includes nonsteroidal anti-inflammatory drugs. Nonsteroidal anti-inflammatory drugs can include:

  • aspirin
  • ibuprofen (e.g. Advil, Motrin)
  • naproxen (e.g. Aleve, Naprosyn)

These drugs are helpful in relieving pain, and reducing inflammation.

Patients can also be prescribed pain medication for long-term treatment, after the initial treatment is complete.

OTHER TRANSVERSE MYELITIS TREATMENT OPTIONS

Some patients have been treated with intravenous cyclophosphamide. Cyclophosphamide is a drug that is often used to treat lymphomas or leukemia. When physicians choose to treat with cyclophosphamide, an experienced oncology team is involved in the administration of the drug.

Patients that experience recurrent TM are sometimes treated with chemical agents that modify immune response. These treatments can include methotrexate, azathioprine, and mycophenolate or oral cyclophosphamide.

What happens after the initial treatment of transverse myelitis?

Following initial treatment, It is critical to keep the patient’s body functioning. There is a chance the patient can experience complete or partial recovery during this time. If the respiratory system is involved, the patient may be placed on a respirator.

Patients that are showing acute symptoms (such as paralysis) are generally treated in a hospital or rehabilitation center. If a paralyzed patient begins to recover limb control, long term physical therapy can be applied to improve range of motion and strength.

In almost all cases, bed rest is often highly recommended during the initial days and weeks after onset of the disorder.

What therapies are used for long term transverse myelitis treatment?

Transverse myelitis treatment is generally tailored to fit the needs of the patient. Each patient can have different levels of disability, different levels of pain, and different symptoms.

Below is a list of both common and less common long term treatments of transverse myelitis:

  • Pain Management
  • Physical Therapy
  • Occupational Therapy
  • Depression treatment and counseling
  • Accupuncture
  • Massage Therapy

PAIN AND SYMPTOM MANAGEMENT

Physicians may prescribe medication for long-term treatment depending on the patient’s symptoms and any complications the patient may be experiencing.


Some patients experience painful muscle spasms, and will therefore often be prescribed anti-spasticity drugs.

In transverse myelitis, the nerve impulses from the spinal cord are often scrambled and misinterpreted by the brain as pain. Painkiller medications can also assist patients with easing pain discomfort. Some physicians prescribe anticonvulsants to relieve the pain and discomfort caused by transverse myelitis.

Below is a list of medications that are often prescribed for pain and discomfort in transverse myelitis patients:

  • gabapentin (Neurontin)
  • pregabalin (Lyrica)
  • baclofen (Kemstro and Lioresal)
  • prednisone

PHYSICAL THERAPY

Physical therapy treatments helps patients build muscle strength and recover coordination. Physical therapists recommend and teach patients to use various assistive devices. Assistive devices can include things such as wheelchairs, canes, and braces.

 

OCCUPATIONAL THERAPY

This type of therapy assists transverse myelitis patients with learning new ways to perform day to day activities, such as bathing, cooking, and housecleaning.

DEPRESSION TREATMENT AND COUNSELING

Depression can be quite common in patients with spinal cord disorders. In general, depression is common in individuals suffering from any type of disability.

Similar to any depression treatment, patients are generally treated with both medications and counseling.

Common depression medications can include:

  • Selective Serotonin Reuptake Inhibitors class antidepressant medications. These can include medications such as: paroxetine (Paxil), fluoxetine (Prozac), escitalopram (Cipralex), citalopram (Celexa), fluvoxamine (Luvox), and sertraline (Zoloft)
  • Serotonin Norepinephrine Reuptake Inhibitors class antidepressant medications. These can include medications such as: venlafaxine XR (Effexor XR)
  • Tricyclic Antidepressants such as amitriptyline (Elavil), desipramine (Norpramin), imipramine (Tofranil), maprotiline (Ludiomil), and nortriptyline (Nortriptyline)
  • MAO Inhibitors class antidepressant medications. These include medications such as: moclobemide (Manerix), phenelzine (Nardil), and tranylcypromine (Parnate)
  • Tetracyclic antidepressants medications such as mirtazapine (Remeron)

If you, or someone you know, is suffering from depression, please seek advice from a physician as quickly as possible.

ACCUPUNCTURE

Some individuals living with transverse myelitis have had success with accupuncture. There is no evidence that this therapy works, but it has been deemed successful by some individuals.

MASSAGE THERAPY

Some individuals living with transverse myelitis have had success with massage therapy. Although the therapy probably does not help the condition itself, it is quite possible that it relieves other symptoms that are triggerred by symptoms of transverse myelitis. For example, leg weakness can cause individuals to walk differently and put strain on parts of the body such as the back or hip. Massage therapy has been deemed successful by some individuals with transverse myelitis.

What day to day adaptations are required for a person with transverse myelitis?

There are numerous physical, psychological, and emotional adaptations that a person with transverse myelitis can struggle with on a day to day basis. The level of physical adaptation is generally dependent on the level of remaining disability. However, the level of psychological and emotional adaptation can vary from individual to individual. These factors may not necessary be dependent on the level of physical disability caused by transverse myelitis.

Physical adaptations are related to learning to live with the disabilities. This can include learning to cope with bowel and bladder control, sexuality dysfunction, inability to control muscles, spasticity issues, mobility issues, pain management, and sometimes the inability to perform basic daily functions such as dressing and cooking.

What new treatments or experimental treatments are available?

Information in this area is currently lacking. There is no indication that there is alot of Transverse Myelitis research happening right now. You might be interested in reading about CCSVI.

CCSVI (CHRONIC CEREBROSPINAL VENOUS INSUFFICIENCY)

CCSVI is a condition where there are blockages and/or narrowing of the veins that are supposed to drain the blood from the brain back to the heart. It is currently a popular topic in the news because a large percentage of Multiple Sclerosis patients have been found to have CCSVI, and the CCSVI treatments have been quite successful in some patients. This, of course, sounds very promising for MS patients.

How does this relate to TM? Well, a number of patients diagnosed with Transverse Myelitis eventually go on to develop Multiple Sclerosis (or they were wrongly diagnosed to begin with), so this news is quite relevant. Furthermore, CCSVI has been reported in individuals with other neurological conditions, so it is possible that Transverse Myelitis could be one of them.

A simple and non-invasive doppler ultrasound test can indicate whether a patient is affected by CCSVI. CCSVI treatment is considered experimental in many parts of the world, and therefore may not yet be available in your area.

Keep up to date with CCSVI News and Information. Testing and diagnosis will likely be available in your area soon, and could potentially provide important information to any person suffering from a neurological disorder!

Please take a look at the personal experience page where at least one individual with Transverse Myelitis has undergone successful CCSVI treatment.