Acute myelitis is very rare, but leads to serious consequences, up to disability. This disease can have different places of localization, as it covers several departments or the entire spinal cord. Transverse myelitis is much easier to treat than other types of the disease, but it greatly violates the integrity of the tissues of the spinal cord.
What is myelitis
The disease acute myelitis is characterized by the fact that there is inflammation of the spinal cord, as a result of which both gray and white matter suffers . A person immediately feels the course of the inflammatory process, since the functioning of the spinal cord is disrupted.
The inflammatory process is very dangerous, as it leads to the fact that:
- movements are disturbed;
- numbness is observed;
- paralysis of the limbs.
If treatment is not done in a timely manner, then the inflammatory process goes to the lower part of the brain.
Transverse myelitis
Acute transverse myelitis manifests itself in the form of pain in the neck, after which paresis, paresthesia, and malfunctioning of the pelvic organs may gradually develop. Soreness is growing rapidly, literally in a few hours or days. The severity of the course of the disease can also be different, so it is important to pay attention to the problem in a timely manner.
In very complex cases, initially all reflexes completely disappear, and then hyperreflection occurs. If constant paralysis is observed, then this indicates the death of some segments of the spinal cord. Often this type of myelitis occurs against the background of influenza, measles, as well as many other infectious diseases. Vaccination can provoke the formation of an inflammatory process.
Often, the disease manifests itself during the recovery period after an infectious disease. This disorder becomes the first sign of the occurrence of multiple sclerosis. In this case, it does not depend on vaccinations and infection.
Primary and repeated forms of damage
Primary forms of acute myelitis of the spinal cord are very rare and occur when exposed to:
- influenza viruses;
- encephalitis;
- rabies.
The secondary form of the disease is considered a complication of syphilis, measles, sepsis, scarlet fever, pneumonia, tonsillitis. In addition, the disease can occur as a result of the presence of purulent foci. The causative agent of the disease enters the body through lymph or brain tissue.
The disease can be observed in patients at different ages, but most often occurs in middle-aged patients. The inflammatory process in the thoracic and lumbar region is localized. Together with general malaise, patients feel severe back pain. The symptomatology of the disease largely depends on the severity of its course.
Myelitis Classification
Classification of acute myelitis is carried out according to several criteria. This disease is divided into the following types:
- viral;
- traumatic;
- infectious;
- toxic;
- post-vaccination.
According to the mechanism of its development, the disease is divided into primary or secondary type. At the same time, it is worth noting that the secondary type of myelitis occurs against the background of many other diseases. According to the duration of the course, it is divided into:
- subacute;
- acute;
- classical.
The inflammatory process is divided into several different types and prevalence. In this case, multifocal, diffuse and limited myelitis are distinguished. Transverse myelitis is of a limited type, since it is only an insignificant focus of the inflammatory process.
Causes of occurrence
Acute myelitis in neurology is described as a disease that can be triggered by a variety of factors. It is divided into two main groups formed by the principle of the sequence of formation of the inflammatory process. The primary form of the disease occurs due to infection or injury to the spinal cord. The secondary form of the disease occurs against the background of other diseases.
Infection can enter the circulatory system through an open wound. Viruses can enter the human body through the bites of insects, infected animals, as well as non-sterile medical equipment. Secondary foci of the infectious process are formed in the spinal cord when affected by such pathogens:
Among the traumatic causes of the formation of the inflammatory process, we can distinguish the following:
- irradiation;
- electric shock;
- decompression sickness.
In neurology, acute myelitis can also occur due to a violation of metabolic processes, which include:
- diabetes;
- anemia;
- chronic liver disease.
In addition to all these reasons, the inflammatory process can be triggered by the penetration of various toxic substances, heavy metals into the body. Inflammation can also be triggered by vaccination against one of the viral diseases.
Development mechanisms
Acute myelitis can occur as a result of infection entering the body through the blood or spinal nerves. Initially, the space passing between the membranes is infected, and then only the main brain tissues are involved in the pathological process.
The spinal cord is divided into separate segments, each of which corresponds in size to the vertebrae. Each of them is responsible for reflexes and transmits certain signals to the brain from internal organs and muscle groups. Depending on the number of affected segments, myelitis can be limited, distributed over all parts of the spinal cord or localized in neighboring and unrelated areas.
Symptoms of the disease
Initially, with the course of acute myelitis, symptoms appear that are characteristic of absolutely any inflammatory process in the body. A sharp increase in temperature is characteristic of this disease. At the same time, there may be aching in the bones, a feeling of general malaise, chills, fatigue. In this regard, many take this disease for a simple cold.
Neurological disorders appear much later, when the lesion manifests itself in the form of pain in the affected area. Discomfort in this case extends not only to the back, but also to the limbs, giving it to the internal organs. Symptoms largely depend on the area of localization of the inflammatory process. Loss of sensitivity, as well as shuffling of the legs is observed with damage to the lumbar region. However, there is a lack of reflexes and impaired functioning of the pelvic organs.
With the localization of the inflammatory process in the cervical spine, the main sign of damage will be difficulty breathing, pain when swallowing, and also speech impairment. In addition, there is general malaise, weakness and dizziness. Thoracic myelitis is expressed in the stiffness of movements and the presence of pathological reflexes. In this case, there may be impaired functioning of some organs.
If signs of the disease are detected, you should definitely consult a doctor to diagnose and treat acute myelitis, since over time the situation can only get worse. This threatens with disability and the deprivation of the ability to move normally.
Diagnostics
The diagnosis of acute myelitis can only be made after a comprehensive examination. Initially, the doctor collects an anamnesis, and also examines the patient. To assess the severity of the course of the disease, the doctor prescribes a neurological examination, which includes:
- sensitivity assessment with identification of the area of violation;
- determination of muscle tone of affected limbs;
- reflex test;
- determination of violations by internal organs.
Diagnosis of acute myelitis is also carried out using laboratory research methods that will help establish the main cause of the inflammatory process. These methods include:
- general and biochemical blood analysis;
- cerebrospinal fluid analysis ;
- blood serology.
Instrumental techniques allow to determine the localization and degree of prevalence of the pathological process. A final diagnosis may require consultation with a neurosurgeon.
Complex treatment
The treatment of acute myelitis largely depends on how much the spinal cord is affected, and which segment of it affected the inflammatory process. Often the patient requires urgent surgical intervention. The operation makes it possible to eliminate pressure on the vertebrae and the spinal canal, which can provoke the onset of pain.
To eliminate temperature and inflammation, antipyretic drugs and antibiotics are prescribed. In the course of therapy with bedridden patients, it is necessary to include measures to combat bedsores, namely the treatment of skin with camphor oil, lining of rubber rings and a frequent change of bed linen. In case of malfunctioning of the internal organs, anticholinesterase drugs are initially prescribed for urine output, and then catheterization and rinsing of the bladder with antiseptic solutions are required.
To restore the patient's ability to move normally, the doctor prescribes Prozerin, Diabazole, and vitamin B. The use of medications should be combined with therapeutic exercises and massage.
What can be the complications
Acute myelitis can cause the patient to remain bedridden for life. In some cases, when the advanced stage of the disease progresses, it can lead to the death of the patient. If the pathological process has spread to the neck, and paralysis of the abdominal and pectoral nerves is also observed, then this can lead to problems with the respiratory system. Purulent lesions can provoke sepsis, which ultimately leads to the death of tissues.
Preventative measures
Prevention means timely vaccination against infectious diseases that provoke the occurrence of an inflammatory process in the region of the brain and spinal cord.
Poliomyelitis can provoke a violation of the motor function of the cervical spine. Mumps affect the salivary glands. Measles is characterized by the appearance of cough and rashes on the skin and oral mucosa. In order to prevent infection, you need to be very careful about your health and if absolutely any signs of malaise occur, immediately consult a doctor for treatment.
The course and forecast
The course of the disease is very acute and the pathological process reaches its greatest severity just a few days after infection, and then stability is observed for several weeks. The recovery period can be from several months to 1-2 years. First of all, there is a restoration of sensitivity, and then the function of internal organs. Motor functions recover very slowly.
Often, for a long time, the patient has persistent paralysis of the limbs or paresis. Cervical myelitis is considered to be the most severe in its course, since the inflammatory process proceeds in close proximity to vital centers and respiratory organs.
An unfavorable prognosis is also observed for lumbar myelitis, since as a result of the acute form of the disease, the functions of the pelvic organs recover very slowly, and as a result, a secondary infection can join. The prognosis worsens in the presence of concomitant diseases, in particular, such as pneumonia, pyelonephritis, as well as frequent and severe pressure sores.
Patient capacity
The patient's ability to work is largely determined by the prevalence and localization of the pathological process, the degree of sensitive disorders and impaired motor functions. With the normal restoration of all the required functions, the patient can return to his usual work after some time.
With residual effects in the form of lower paresis, as well as sphincter weakness, patients are assigned the 3rd disability group. With a clear violation of the gait, the patient is given 2 disability groups. And if a person needs constant outside care, then he is assigned 1 group of disability.