Transverse Myelitis: Snapshot of a rare disease

Transverse Myelitis (TM) is an autoimmune condition that affects the spinal cord. It classically can cause weakness, loss of sensation, pain and bowel or bladder dysfunction. It has historically been separated from multiple sclerosis and acute disseminated encephalomyelitis by the fact that only the spinal cord is affected, presumably leaving the brain undamaged. This description of the disease is based on MRI images of patients acquired as part of clinical evaluations that show a lack of damage to the brain. In 2012, for the first time, our team at UT Southwestern and Children’s Medical Center Dallas identified a significant number of TM patients with evidence of cognitive dysfunction in areas such as attention and memory. Such cognitive dysfunction has the potential to interfere with daily functioning (i.e., learning, school and work performance) and threaten one’s quality of life. Findings from this study raised a concern for unrecognized brain-based damage in patients with TM. It has been known for some time that MRI techniques do a poor job of visualizing changes within the cortex – the outer lining of the brain. We hypothesize that TM patients with cognitive dysfunction may have experienced cortical damage that are not readily apparent on normal MRIs.

Transverse myelitis is a neurological condition in which the spinal cord is inflamed. The inflammation damages nerve fibers, and causes them to lose their myelin coating leading to decreased electrical conductivity in the central nervous system. Transverse implies that the inflammation extends across the entire width of the spinal cord. Partial transverse myelitis and partial myelitis are terms used to define inflammation of the spinal cord that affects part of the width of the spinal cord.