Symptoms and Treatment of Myelitis
Dec 21, 2020
Source: Cainiu Health
Dr. Zhong Mengfei
Introduction
Symptoms of myelitis:
1. Motor dysfunction: upper motor neuron paralysis below the affected spinal segment;
2. Sensory impairment: decreased or absent sensation below the affected spinal segment;
3. Autonomic nervous system symptoms: urinary retention or constipation commonly occur during the acute phase.
Treatment of myelitis:
1. General management: bed rest is recommended during the acute phase;
2. Pharmacotherapy: corticosteroids (e.g., adrenal cortical hormones) are administered.
Myelitis is a disease caused by infection or toxin exposure affecting the spinal cord. Because lesions in the spinal cord are often transverse, it is also known as transverse myelitis. So, what are the symptoms and treatments for myelitis? Below, we provide answers to these questions.
Symptoms of Myelitis
1. Motor Dysfunction
The primary manifestation is upper motor neuron paralysis below the level of the lesion. However, in acute-onset cases, an initial transient flaccid paralysis—termed “spinal shock”—may occur. Within days to weeks, hyperreflexia, increased muscle tone, and pathological reflexes gradually develop. Muscles corresponding to the affected spinal segment exhibit lower motor neuron paralysis; however, classic signs are often absent—a hallmark feature of myelitis.
2. Sensory Disturbances
Sensation is diminished or lost below the level of the lesion. Both superficial and deep sensation are variably impaired, though severity may not be symmetrical bilaterally. If only one side of the spinal cord is involved, pain and temperature sensation are lost on the contralateral side below the lesion level, while deep sensation is lost ipsilaterally. A zone of hyperalgesia commonly occurs at the interface between normal and abnormal sensation—another characteristic feature of myelitis.
3. Autonomic Nervous System Symptoms
During the acute phase, urinary retention or constipation is common. After resolution of spinal shock, urinary incontinence may gradually develop; some patients ultimately develop an autonomous bladder. Depending on the spinal level affected, additional autonomic dysfunctions may arise—including Horner’s syndrome, vasomotor abnormalities, disturbances in sweating and trophic function, and visceral dysfunction.
Treatment of Myelitis
1. General Management
During the acute phase, strict bed rest is recommended, along with a diet rich in calories and vitamins. Adjunctive therapies may include intravenous administration of ATP, coenzyme A, adenosine, or cytidine diphosphate-choline (CDP-choline) to support neural recovery. Additionally, small-volume, repeated transfusions of fresh plasma from healthy donors may help enhance immune function, thereby aiding infection prevention and recovery.
2. Pharmacologic Therapy
Corticosteroids are an effective treatment for myelitis, given the strong association between its pathogenesis and autoimmune mechanisms. Corticosteroid therapy can therefore modulate the immune response and achieve therapeutic benefit. Dosage must be individualized according to disease severity and clinical response.
The above outlines the key symptoms and treatment approaches for myelitis. We hope this information proves helpful.
