Myelitis and acute transverse myelitis
Myelitis, or inflammation of the spinal cord, can result from several diseases. Poliomyelitis affects the cord’s gray matter and produces motor dysfunction; leukomyelitis affects only the white matter and produces sensory dysfunction. These types of myelitis can attack any level of the spinal cord, causing partial destruction or scattered lesions.
Acute transverse myelitis, which affects the entire thickness of the spinal cord, produces both motor and sensory dysfunctions. This form of myelitis, which has a rapid onset, is the most devastating.
The prognosis depends on the severity of cord damage and prevention of complications. If spinal cord necrosis occurs, the prognosis for complete recovery is poor. Even without necrosis, residual neurologic deficits usually persist after recovery. Patients who develop spastic reflexes early in the course of the illness are more likely to recover than those who don’t.
Acute transverse myelitis has various causes. It commonly follows acute infectious diseases, such as measles or pneumonia (the inflammation occurs after the infection has subsided), and primary infections of the spinal cord itself, such as syphilis or acute disseminated encephalomyelitis.
Acute transverse myelitis can accompany demyelinating diseases, such as acute multiple sclerosis, and inflammatory and necrotizing disorders of the spinal cord, such as hematomyelia.