Transverse Myelitis (TM) is the development of grey and white matter inflammation of the spinal cord, which can result in demyelination.
Hallmark characteristics of this condition include: (1) isolated spinal cord (not brain) dysfunction, and (2) the lack of associated cord compression.
TM can be acute or subacute, such that it progresses over the course of hours to several days. Nearly half of cases will reach its maximal deficit within 1 to 10 days of onset.
The diagnosis of TM is primarily based on the history and physical examination findings. MRI of the spinal cord and myelography are often used as diagnostic adjuncts.
This condition typically presents with paresthesias, back pain, and ascending leg weakness.
Febrile illnesses often serve as a precursor; one series found this to be the case in 37% of complete TM cases.
While steroids are sometimes administered over the first several days of illness to decrease inflammation, there is no cure for TM and treatment is largely supportive in nature.
References
Knebusch M, Strassburg HM, Reiners K. "Acute Transverse Myelitis in Childhood: Nine Cases and Review of the Literature ." Dev Med Child Neurol. 1998;40(9):631-9.
