ABSTRACT
Transverse encephalomyelitis This is an acute inflammation of the spinal cord that evolves in hours or days. It affects teenagers and older age groups. It may be associated with demyelination of the CNS. It may follow infectious illness or immunization, but there is no supportive evidence for this. There are both motor and sensory signs and the thorax is the usual level of myelitis. Asymmetrical leg weakness is common. There is a bladder-emptying problem, with increased or reduced tendon reflexes in the lower limbs. Recovery usually starts after a week and may be incomplete. Fifty per cent will recover completely, 40% will recover incompletely, and 10% will not recover. MRI of the spine shows cord compression and swelling at the level of the myelitis. CSF shows raised white cells and elevated IgG. Corticosteroids are used in treatment: high-dose IV for 3 days followed by a minimum of 4 weeks oral. The bladder problem may require rehabilitation and involvement of the urologist and specialist nurse.
