Transverse myelitis - types, symptoms, treatment methods. Causes, treatment and consequences of myelitis Disseminated myelitis

Myelitis spinal cord- an inflammatory process that develops in individual segments, roots, vertebral bodies, processes and other structures of the spinal column. It is quite rare, but is characterized by serious complications.

Types of disease

Depending on the location of the infectious focus and the characteristics of the pathological process, there are several types of myelitis.

The main classification is based on intensity clinical manifestations diseases. In this regard, acute myelitis is distinguished, subacute and chronic.

Most often, pathology develops in the thoracic spine; the lumbar and cervical regions are affected much less frequently. Myelitis can be localized in one segment, surrounding structures, or spread to different parts of the spinal cord. There are the following types of disease:

Limited, or focal. Does not extend beyond 1 segment.
Multifocal, scattered or disseminated. Areas of inflammation of varying intensity occur in different parts of the spinal cord.
Transverse. The disease covers several adjacent segments within one department.
Diffuse, or widespread. The entire spinal cord is involved in the pathological process. Moreover, the intensity of inflammation differs in the thoracic, cervical and other parts of the spine.

Causes of the disease

Myelitis can be primary or secondary. The primary form develops under the influence of neurotropic viruses and is quite rare. The other option is more common, since the reasons for its occurrence are very diverse. These include:

The likelihood of pathology occurring increases in people with weakened immune systems, after hypothermia, overheating, physical or mental stress and other factors.

Characteristic signs

What is myelitis? This is an inflammation of the spinal cord; accordingly, the main clinical manifestations are symptoms of the inflammatory process:

pain;
edema;
skin redness;
local temperature increase;
mobility impairment.

The severity of the symptoms depends on the location of the pathological focus and its prevalence.

Myelitis is characterized by the presence of a prodromal period, during which patients complain of weakness, a slight increase in body temperature, pain and muscle aches.

Acute transverse myelitis is characterized by rapid progression. The person's condition is rapidly deteriorating. The temperature rises to febrile levels, pain appears in the thoracic region spine. Paresthesia develops - weakness lower limbs, sensation of crawling, numbness. Tactile sensitivity in the arms and legs decreases and even disappears. The normal functioning of the pelvic organs is disrupted. A person is unable to fully control the functioning of the bladder and intestines. Paralysis of the lower extremities cannot be ruled out.

Common myelitis is characterized by the appearance of pathological foci in all parts of the spine. In this case, the clinical manifestations differ on the right and left sides of the body. Deep reflexes are impaired or even completely absent.

In subacute and chronic myelitis, the signs of the disease are vague. Symptoms largely depend on at what level of the spine the inflammation is localized. When the lumbar or thoracic region is affected, paresthesia develops in the lower extremities; when the neck is involved in the pathological process, sensitivity is impaired not only in the legs, but also in the arms. Lack of treatment leads to the development of paralysis. Their danger lies in poor circulation and tissue nutrition, resulting in a high risk of developing bedsores.

The disease most often occurs soon after exposure to a provoking factor - trauma, previous infectious or viral disease, administration of immunobiological drugs, etc. And only with the radiation version of myelitis does the pathology develop 6-12 months later, and in some cases even 2 years after exposure to radioactive radiation . This makes it much more difficult to determine the cause.

Diagnostics

To make a diagnosis of myelitis, one examination and collection of anamnestic data is not enough. A comprehensive and comprehensive examination is required, including the use of laboratory tests and instrumental methods.

Diagnosis of the disease includes a neurological examination. The doctor determines the limits of sensitivity loss. An important role is played by the presence of conduction type disturbances (horizontal direction). Evaluates muscle tone and strength of the limbs, the preservation of deep reflexes.

IN general analysis blood, an increase in the level of leukocytes, erythrocyte sedimentation rate, the presence of C-reactive protein and fibrinogen is determined. If an infectious or viral etiology of the disease is suspected, antibodies to certain pathogens are determined in the blood. There are signs of inflammation in the cerebrospinal fluid.

Of the instrumental diagnostic methods, the following procedures are recommended:

ENMG (electroneuromyography). Allows you to evaluate the conductivity of nerve impulses, establish the level of disturbances and localization of the pathological process.
MRI. Makes it possible to obtain detailed layer-by-layer images of the spinal cord. With their help, it is easy to determine the boundaries of the infectious focus.

Drug therapy

Treatment of myelitis primarily depends on what led to the development of the disease. The complex therapeutic regimen includes symptomatic medications, the purpose of which is to improve the patient’s condition.

The following groups of medications are used in the treatment of the disease:

Broad-spectrum antibacterial drugs in maximum doses. They are used regardless of what caused the inflammation of the spinal cord. This will help prevent a secondary infection from joining and spreading throughout the structures of the spinal cord.
Systemic antiviral drugs. Herpetic myelitis requires long-term use of these drugs.
Glucocorticosteroids. They have powerful anti-inflammatory properties, which will help relieve inflammation and improve the patient’s well-being. In allergic myelitis it has an antihistamine effect. The duration of hormonal therapy is determined by the attending physician individually, depending on the patient’s condition.
Antipyretics. Used when body temperature rises above 38°C. Mostly drugs based on Paracetamol or Ibuprofen are used in age-related doses.
Analgesics. For severe pain, treatment includes medications from the NSAID group. If positive effect from their use, a decision may be made on the advisability of using narcotic analgesics.
Immunostimulants. Effectively strengthen the immune system and increase the body's own defenses.
Muscle relaxants. Relieves muscle tone and promotes muscle relaxation.
Diuretics. Myelitis is accompanied by dysfunction of the pelvic organs. The use of diuretics will prevent stagnation of urine in the bladder and the development of an inflammatory process in the urinary tract.

Patient care and additional activities

Proper patient care plays an important role in the successful treatment of the disease. If there is no natural urination, it is necessary to perform catheterization of the bladder. The patient must be turned over and treated regularly antiseptics areas of the body that are subject to the greatest stress. Carefully straighten the bed linen so that no wrinkles remain. Such measures will help prevent the development of bedsores.

Treatment folk remedies can provide effective assistance in the treatment of the disease. However, any method should be previously agreed with the attending physician in order to prevent a deterioration in the patient’s well-being.

The patient's recovery takes quite a long time. During this period, it is necessary not only to take prescribed medications, but also to undergo a course of physiotherapeutic procedures. Don't neglect your studies physical therapy. Regular exercise will help strengthen muscles and restore tone. Good results gives a massage.

What can the disease lead to?

The prognosis after the disease depends on the degree of damage to the spinal cord and the location of the pathological focus. The most dangerous is upper cervical myelitis, which most often leads to death. The occurrence of inflammation in the thoracic or lumbar region threatens the development of paralysis of the lower extremities and complete disability of the patient.

The highest chances of a person’s recovery after myelitis are observed with timely treatment. medical care. If the patient consults a doctor at the stage of loss of sensation in the limbs, the percentage of complete recovery will be much lower.

Transverse myelitis is a disease inflammatory in nature, affecting the myelin sheath of the spinal cord (SC).

Subsequently, the bodies and processes of nerve cells, spinal cord roots, as well as blood and lymphatic vessels are involved in the pathological process.

The disease occurs with equal frequency in men and women; the age groups at risk are people from 10 to 19 and from 30 to 39 years, of which 28% of cases are children.

Depending on the location of the inflammatory process:

focal - there is one focus of the disease in the spinal cord;
multifocal - more than one focus of inflammation;
transverse – is focal, but distinctive feature is that the inflammation covers several adjacent spinal segments;
diffuse - the lesion is distributed throughout the spinal cord, and is expressed in varying degrees.

By duration:

spicy;
subacute;
chronic.

The definition of “transverse” does not mean that the entire diameter of the SM is involved in the process. This part of the term reflects the manifestation of a violation of surface sensitivity with the formation of a clear transverse level.

Causes

Etiological classification of transverse myelitis:

Infectious. It is the cause in 50% of pathology cases:

Infectious transverse myelitis should be divided into two types: primary (the infection initially affected the SM) and secondary (the infection entered the SM from other foci by hematogenous route)

Postinfectious myelitis. Develops approximately 4 weeks after diseases such as measles, whooping cough, chicken pox, etc.;
Traumatic. Occurs as a result of spinal injury, which can lead to damage to the spinal column and infection to the existing wound;
Intoxicating. Occurs due to damage to SM cells by poisons as a result of poisoning. Among these poisons may be medicinal and narcotic substances, heavy metals (such as mercury, lead), etc.;
Vaccine-associated myelitis. Develops after oral administration of a live vaccine containing a weakened polio virus;
Radiation myelitis. Develops as a result of damage to the brain by ionizing radiation.

It is worth noting the advantage of an inactivated vaccine, which is not capable of causing disease, because contains killed polio virus.

Routes of infection

Ways of infection with infectious transverse myelitis:

Fecal-oral. For example, if the disease is caused by the polio virus;
Airborne (poliomyelitis virus, influenza virus);
Transmissible, i.e. through insect bites (tick-borne encephalitis virus);
Hematogenous. As mentioned above, a secondary focus in the SM can form when the infection spreads from primary foci (for example, with tuberculosis);
Infectious agents can enter the spinal cord through open spinal trauma;
Through animal bites (rabies virus).

Symptoms

Increase in general temperature to 39-40°C, general weakness. Pain localized at the site of the affected area of the spinal cord.

The cervical and thoracic regions of the spinal cord are most often affected, and less commonly the lumbar region.

Pain localized along the midline of the body in the dermatome corresponding to the affected area of the spinal cord (dermatome is a segment of skin innervated by one spinal cord root).

Neurological disorders are based on the destruction of the myelin sheath, which disrupts the efferent (descending, centrifugal) and afferent (centripetal, ascending) transmission of impulses in the nervous system. Symptoms associated with this pathological mechanism begin 2-3 days after the onset of the disease.

Neurological disorders:

Pelvic disorders – disturbance of urination and defecation (possible development of ascending cystitis followed by sepsis). Observed when the thoracic segments of the SM are affected.
Paraparesis manifests itself in the weakness of certain muscle groups of both extremities (lower or upper):
monoparesis – decreased muscle strength in one limb;
triparesis – in three limbs;
hemiparesis – in the limbs of one half of the body;
tetraparesis – muscle weakness in all four limbs. Appears when the upper segments are affected cervical spine CM.
Breathing disturbance, even to the point of stopping. It develops in cases where the lesion affects the phrenic nerve.
Reduced motor activity or its complete absence (paralysis) in the lower extremities, urinary and fecal incontinence - with damage to the lumbar segments of the spinal cord.
Sensory disturbances below the site of the pathological focus.
A change in gait that occurs due to paresis of the lower extremities (the patient drags his leg while walking).
Reflexes:
Babinsky - when the handle of the hammer is lightly passed along the lateral edge of the foot, in response to irritation the patient extends the toes in a fan-shaped manner;
Oppenheim - when the handle of the hammer is passed along the crest of the tibia, pathological extension is observed thumb leg being tested;
Schaeffer - when the Achilles tendon is compressed, the big toe extends;
Gordon - with compression calf muscles, there is a slow extension of the big toe, and a fan-shaped divergence of the remaining toes of the same foot.

Some people experience cramps in their toes. Let's look at why this happens and what to do.

Diagnosis and treatment

The diagnosis of transverse myelitis is made on the basis of symptoms, in which neurological disorders play an important role.

Held Comparative characteristics symmetrical limbs, tests for pathological reflexes, study of muscle strength, which is assessed on a special scale.

The patient is asked to perform the movement characteristic of the joint and, counteracting with the hand, the muscle strength is determined:

5 – the patient offers good resistance to the doctor’s force;
4 – the force is minimally reduced, the patient resists the doctor’s actions, but is forced to use more force;
3 – the strength is reduced more than in the previous version, the doctor manages to prevent the limb from bending;
2 – the patient’s movements are possible only in a relaxed position or with the help of a doctor;
1 – the patient does not move, but the doctor feels the tension of his muscles;
0 – no movement, no muscle tone.

MRI and CT diagnostics are used to detect the location and extent of spinal cord damage. In a general blood test, leukocytosis is observed with a shift to the left (i.e., blast forms of leukocytes predominate), increased ESR (erythrocyte sedimentation rate), increased fibrinogen and C-reactive protein, and antibodies to infectious agents.

Compound cerebrospinal fluid may not change, but sometimes an increase in protein, autoantibodies, and an increase in lymphocytes is detected.

Treatment

Conservative treatment:

antibacterial drugs;
antiviral drugs;
analgesics;
sedatives;
antipyretics;
strict bed rest;
glucocorticosteroids.

To prevent urinary retention, anticholinesterase drugs are used; if they do not help, then catheterization of the bladder is performed.

Prevention of bedsores:

soft cushions are placed under the sacral area and under the heels;
the skin is wiped with a weak solution of manganese or camphor alcohol;
physiotherapy.

To improve the conduction of nerve impulses, vitamin B is prescribed. After treatment, sanatorium-resort treatment and physical therapy are recommended.

Surgical treatment is indicated in the presence of purulent foci in the vicinity of the spinal cord and when compression of the spinal cord occurs.

The danger of transverse myelitis lies in the damage to such a highly organized structure as nervous tissue. Its destruction, followed by scar formation, leads to lifelong complications in motor activity and sensitivity of body parts, in particular the upper and lower extremities.

The disease is not self-curable and requires urgent medical care in a hospital setting, therefore, it is possible to prevent irreversible complications only by immediately contacting medical institution.

Video on the topic

Inflammation of the spinal cord is a condition dangerous to human health and life. In the absence of timely medical care, it leads to permanent disability due to loss of mobility of the upper or lower extremities.

Myelitis of the spinal cord can develop under the influence of external and internal pathogenic factors. Very often, aseptic inflammation is diagnosed against the background of a sequestered hernia (severation of a section of the nucleus pulposus and its slipping into the spinal canal.

It may also be infectious lesion when the pathogen penetrates through the lymphogenous or hematogenous route. With penetrating wounds of the back and neck, an atypical form of an infectious agent can be introduced.

Less common are cases of myelitis associated with tick-borne encephalitis.

In this material, we propose to analyze the typical symptoms of inflammation of the spinal cord and treatment methods that allow us to give a positive prognosis for recovery and full recovery mobility of legs and arms. In most cases, the appearance of symptoms of spinal cord myelitis leaves no doubt about the preliminary diagnosis, therefore, after a special diagnosis, conservative treatment is quickly prescribed drug treatment. It is carried out at the initial stage exclusively in a specialized hospital. After discharge from the hospital, rehabilitation treatment continues on an outpatient basis.

Etiology and pathogenesis

The primary pathogenesis of the development of spinal cord myelitis may be based on sequestration of an intervertebral hernia with dorsal localization. In this case, the entire corpus pulposus of the nucleus pulposus or part of it emerges from the membrane of the annulus fibrosus.

This substance has a protein nature. Therefore, the immune system recognizes it as foreign and sends inflammatory reaction factors to the site of its introduction.

Aseptic inflammation of the spinal cord membranes develops, leading to the appearance of severe neurological symptoms.

The type of myelitis and the prognosis of its course depend on the type of pathological changes. Neuromyelitis optica is the least dangerous, since it is characterized by a fairly calm course without pronounced paralysis and damage to the stem structures.

Opticomyelitis occurs mainly in adults; it is not typical for children under 7 years of age. Devic's syndrome has a mild course with a locally limited one phase with a sharp deterioration of the condition and subsequent movement towards convalescence of the patient.

The prognosis for life and restoration of all functions in these cases is always positive.

Secondary types of myelitis related to reactive types are common. They arise as a response to strong infectious processes in other organs and systems.

The most common are tuberculosis, measles, whooping cough and herpetic forms of inflammation of the spinal cord. The etiology of this disease may also be aseptic.

This is usually observed as a result of serious back injuries, often associated with compression of the vertebral bodies, their cracks, protrusions of the intervertebral discs and other unpleasant pathological changes.

Transverse and other types of disease

With selective selective damage to the spinal cord substance by neurotropic forms of pathogens, primary myelitis begins. This type is usually caused by a viral infection that spreads throughout the body through the blood or lymphatic fluid.

The secondary type of spinal cord myelitis is characterized by infection with bacterial pathogenic microflora.

It can also spread hematogenously, and can penetrate through contact when wounded, violating the integrity of the epithelial tissues of the back in the spinal region.

There are known cases of the development of secondary myelitis of the spinal cord after a fall on a dog and a rather deep scratch formed on the skin in the area of the spine. It was already beginning to scar when they stepped on Negative consequences in the form of characteristic symptoms of inflammation of the spinal cord.

During the initial diagnosis, the doctor must determine not only the factor of primary and secondary forms of the inflammatory process. It is also important to record the type of course of the disease.

And it can be acute or chronic, subacute and recurrent. The next stage of classification is to determine the localization of primary changes.

The following options are possible here:

transverse myelitis of the spinal cord involving areas of tissue destruction nerve fiber, located parallel and transverse to each other;
a clearly limited local process is observed more often with sequestration of an intervertebral disc herniation;
disseminated or widespread type is characterized by dispersed localization of numerous foci of the inflammatory reaction;
diffuse myelitis is the most dangerous form, affecting the entire spinal cord and quickly leading to damage to the brain stem.

There are other characteristics present in the plot medical diagnosis. It is necessary to indicate the location of the pathology in relation to the spinal column. This may be cervical, thoracic, lumbar or sacral localization.

All of these factors are of utmost importance for making a prognosis and prescribing effective and timely treatment of the disease.

The main causes of inflammation of the spinal cord

There are various reasons for the development of inflammation of the spinal cord, but myelitis may not always be caused by the penetration of pathogenic microflora.

There are situations when, during differential diagnosis, concomitant organic lesions of the structures of the spinal column were identified in the patient, which led to permanent injury to the dural sac of the spinal cord.

As a result, symptoms of sluggish myelitis arose with a recurrent chronic type of pathogenesis.

The main causes of spinal cord myelitis may include the following influencing factors:

meningococcal infection, provoking the development of purulent severe form, often diagnosed in children under 10 years of age;
complication viral infections(Coxsackie, flu, herpes);
spinal column injury with splintered changes in the bone structure;
carrying out radiation therapy for autosomal and oncological processes;
response to vaccination;
allergic alertness of the body;
metabolic disorder;
immunodeficiency of primary and secondary forms;
general asthenia and decreased vitality;
stressful influence of negative environmental factors, for example, hypothermia or heat stroke.

Eliminating the cause is the basis for quick and successful treatment this pathology. Therefore, it is important to always find negative factors of primary influence and, if possible, completely eliminate them.

Clinical symptoms of inflammation of the membrane and roots of the spinal cord

In most cases, symptoms of spinal cord inflammation appear suddenly, without a prodrome stage. This period of acute primary symptoms can last from two weeks to a month.

At this time, clinical symptoms of spinal cord myelitis can lead to catastrophic consequences.

Sensitivity and mobility of the lower or upper extremities are lost, severe pain and cramps occur, and body temperature rises sharply.

The next stage of myelitic inflammation of the spinal cord membrane can last approximately 5-6 months. During this period, the primary lost functions are restored.

Thus, patients begin to learn to walk again, develop fine motor skills hands, etc. The prognosis for the complete restoration of damaged body functions depends on the success of the rehabilitation carried out at this time.

Next comes the late one rehabilitation period, in the continuation of which there are still pathological changes. But by the beginning of the next stage residual effects Usually all symptoms go away.

Full recovery usually takes 2-3 years.

The clinical picture of myelitis develops according to the following scheme:

in the first 3-4 days the patient is worried about general weakness with high body temperature and muscle pain;
on days 5-6, areas of paresthesia (lack of skin sensitivity) begin to form;
at the same time, the patient notes the manifestation of convulsions, tingling in different parts of the body, trembling;
a week after the onset of the disease, a clinic of secondary paralysis or paresis begins to form;
at the same time, the functioning of the intestines and bladder is impaired (patients may experience urinary and fecal incontinence);
lower or upper limbs lose the ability to move;
a spasm of the muscles of the anterior abdominal wall occurs (the abdomen becomes hard as a board) and intercostal muscles;
severe back pain is present in the first 10 days, then pain syndrome completely leveled;
the patient loses the ability to make any movements;
bedsores and trophic ulcers form.

The myelitis clinic can develop both rapidly (within 12 hours) and very slowly (within 30 - 40 days). In the secondary form of the disease, it is almost impossible to detect the point of onset of inflammation of the spinal cord. The onset coincides with the improvement of the underlying infection.

There are features of the clinical manifestations of various forms of this pathology. Thus, the subacute course is characterized by the preservation of the performance and functioning of all organs and systems.

However, the patient experiences constant persistent back pain.

Increasing paralysis with fecal incontinence and voluntary emptying of the bladder is characteristic of focal localization of the inflammatory process.

And for diffuse myelitis, asymmetry in the manifestation of clinical signs is typical. A stroke-like course is present only with transverse acute inflammation spinal cord; it is not typical for other forms of the disease.

For diagnosis, it is necessary to take cerebrospinal fluid to identify its liquor composition and the presence of blood cells in it.

It is also possible to carry out culture for bacteriological analysis.

Myelography and x-rays of the spinal column allow us to establish the site of the lesion. MRI and CT are necessary to clarify the diagnosis.

Differential diagnosis should exclude tumor processes and consequences of traumatic exposure.

Guillain-Barré polyneuropathy, spinal stroke and epiduritis should be excluded. It is important to test for borreliosis and tick-borne encephalitis.

In the long term, they can give similar clinical symptoms.

Treatment of myelitis (inflammation) of the spinal cord

Treatment of spinal cord myelitis requires hospitalization of the patient for the entire period of acute clinical manifestations. Immediately after admission, the patient is prescribed intensive therapy to maintain the functionality of all life support systems.

Depending on the etiology of the pathological process, antibiotics, sulfonamide drugs, antivirals, fungicides. When sequestration of an intervertebral disc herniation requires emergency surgery for extraction of the nucleus pulposus.

Similar tactics are required for spinal injuries.

Treatment of spinal cord inflammation is not complete without the use of steroids.

Glucocorticosteroids, for example, Hydrocortisone, Prednisolone, are prescribed for intravenous administration in a dosage of up to 100 – 120 mg/day.

If there is a threat of compression of the brain stem, diuretics are used: Furosemide or Lasix intravenously, 2-4 ml/day.

Actively used symptomatic treatment. So, at high body temperature, non-steroidal anti-inflammatory drugs are used.

They also help relieve severe pain. Vitamin therapy is prescribed.

Excellent results are shown by prescribing Milgamma 3 ml daily for 20 days.

After acute clinical manifestations subside, physiotherapy, massage, and physical therapy are prescribed.

Prognosis for recovery of leg mobility in spinal cord myelitis

The prognosis for spinal cord myelitis depends on the form of the pathology, its location and severity. As a rule, doctors give a sharply negative prognosis only for the pus of the meningococcal form of infection. All other types can be treated quite successfully.

The recovery process after spinal cord myelitis may take long time.

The patient is assigned a second non-working disability group with annual medical recertification.

It is believed that complete restoration of leg mobility after spinal cord myelitis is possible after 6-8 months from the onset of the disease.

Preservation of paralysis and paraplegia is possible with transverse inflammation of the spinal cord with a stroke-like course. An outcome of complete recovery is also possible.

And with a similar frequency there are cases accompanied by a gradual progression of all clinical symptoms, ultimately leading to the death of the patient within 5-6 years.

The most unfavorable prognosis is for the lumbosacral localization of the inflammatory focus. There is also a certain danger when the cervical spine is affected.

Source: http://santebone.ru/?p=3555

Myelitis is a fairly rare type of inflammation of the spinal cord. The disease spreads either throughout the entire spine or may affect individual parts of it.

If the disease is not cured in a timely manner, there is a risk of remaining disabled forever.

Myelitis is a kind of inflammation of the spinal cord, as a result of which the white and gray matter suffers.

The human body immediately feels the inflammatory process, because the function of the spinal cord is impaired.

Inflammation threatens with movement disorders, paresthesia, numbness and paralysis of the limbs.

If the disease is not treated, this can lead to the inflammatory process spreading to the lower parts of the brain.

The disease is divided into several types.

Transverse myelitis

This concept hides an acute or subacute form of a non-recurrent inflammatory process in the spinal cord.

The disease manifests itself as pain in the neck or back, after which paresis, paresthesia and problems with the functioning of the pelvic organs may appear.

Unpleasant phenomena develop rapidly - over a few hours or days.

If we talk about the severity of the disease, it can vary: from minor problems with sensitivity to complex damage to the spinal cord. There are also problems with the posterior cord, anterior cords and diameter. Dysesthesia occurs in one leg and then moves up both legs.

In a very advanced case, all reflexes initially disappear, and then hyperreflexia appears. If there is permanent paralysis, this indicates necrosis of segments in the spinal cord.

In half of the cases, this type of spinal cord myelitis occurs due to influenza, measles and other infections. Or vaccination could be the impetus.

The disease often manifests itself in recovery period after an infectious disease, but the pathogen is not detected in the nervous system. This suggests that the transverse form of myelitis depends on the autoimmune reaction that occurs due to infection.

This disorder becomes the first bell before the onset of multiple sclerosis. Here the disease does not depend on infection or vaccinations.

Primary and secondary forms of disorder

Primary forms of the disease are quite rare and appear when exposed to influenza viruses, rabies and encephalitis.

Secondary myelitis is a complication after syphilis, scarlet fever, measles, sepsis, erysipelas, tonsillitis or pneumonia. Purulent foci can also contribute to the manifestation of the disease. The causative agent of the disease enters the body through lymph or brain tissue.

The disease can catch a person in different ages, but is more often observed in middle-aged patients. It is localized in the thoracic and lumbar regions.

Along with the malaise, patients feel back pain. All symptoms of the disease depend on the severity of the course, and this suggests that changes occur below the border of the outbreak.

After the appearance of pain, paralysis begins, problems with the pelvic organs, and sensitivity is lost. At first, the paralysis is somewhat sluggish, but after that it provokes spasms and pathological reflexes.

You can often find impaired blood circulation in tissues, which is why a person develops bedsores. Namely, it is through them that infection enters the body, and blood poisoning can occur.

Provoking factors

The onset of an inflammatory process in the brain can be caused by many factors. Myelitis is classified depending on the pathogen as follows:

Viral. The cause of the disease can be rabies or polio. The onset of the disease is also often provoked by the common flu. Inflammation occurs with measles, typhoid or scarlet fever and sepsis.
Bacterial. Here the causative agent is spirochete and streptococci. More often, this type of myelitis is diagnosed in infants. Thanks to vaccination, the disease is rare in adults.
Traumatic. Appears after injuries to the vessels of the spinal cord. It is trauma that can become the impetus for transverse lesions. The strength of the inflammatory processes depends on the nature of the injury. Traumatic myelitis occurs due to spinal injuries and infection.
Post-vaccination. This is a unique form of the disease in which the trigger for the disease is the vaccination of a person.

In addition to all the described reasons, myelitis can form against the background of any process that depresses immune system and destroys nerve cells.

Clinical picture

During primary myelitis, the virus spreads hematogenously, and viremia is observed before brain damage. Secondary myelitis is affected by allergies and hematogenous penetration of infection into the spinal cord.

The intoxication form of the disease is not very common and develops due to poisoning and intoxication of the body.

Upon observation, you can notice that the brain becomes flabby and swells. Hyperemia, swelling, and slight hemorrhage appear at the site; cells die and myelin disintegrates.

Complex treatment

The acute form of transverse myelitis, in which there is compression and spinal block, must be treated surgically. The same measures are carried out in the presence of any purulent or septic focus near the spinal cord.

If speak about conservative treatment, then in acute cases antibacterial therapy is appropriate. It is also prescribed when there is a suspicion of a bacterial nature of the disease or for the treatment of septic complications.

The average duration of treatment is about two weeks. Patients are being treated with Prednisolone. The dose should be reduced from the 10th day of taking the drug, and the course of treatment can last up to 6 weeks.

Hormonal medications are combined with potassium. Often, potassium orotate is used, which has anabolic properties.

Cinnarizine;
Trental;
Ascorbic acid;
vitamins B.

If there is no urination, specialists perform bladder catheterization several times a day. Along with this, the following medications are prescribed:

Furagin;
Furadonin;
Furazolidone.

It is very important to feed the patient properly and take good care of him: maintain the desired body position, use pads and suspensions, wash the person every day with soap and wipe the skin with alcohol.

Do not forget to clean bedsores from necrotic mass using clean wipes soaked in trypsin solution.

The bedsores themselves should be washed with hydrogen peroxide.

If pus is released from the wounds, then it is appropriate to use tampons with sodium chloride, and apply Vishnevsky ointment or sea buckthorn oil to the cleaned surface.

To speed up the healing of bedsores, you can wash them with freshly squeezed tomato juice or Insulin.

When the process stabilizes, they begin to restore the body. Doctors prescribe massage, heat treatments, electrophoresis on the back and orthopedic measures.

During this period of therapy, the patient should take the following medications:

Galantamine;
Dibazol;
nootropics;
amino acids.

If the muscles are severely cramped, then Mydocalm is prescribed. Six months after treatment, the patient can visit sanatoriums and various resorts.

What are the consequences

The prognosis is positive if spinal cord myelitis occurs in the acute phase and the inflammation has not spread throughout the transverse cord.

The sooner improvement occurs, the better. If this is not observed after 3 months, then this may indicate that the patient will forever remain bedridden or death.

The prognosis is difficult when myelitis has spread to the neck and when there is paralysis of the thoracic and abdominal nerves.

The prognosis is also affected by the type of infection that caused the disease. The diagnosis is made by the acute form of the disease with fever, the presence of an infectious disease or purulent lesion.

How to prevent inflammation from occurring

Today it is appropriate to vaccinate the population, which protects against infectious diseases, causing inflammation membranes of the spinal cord and brain:

Polio– an infection that affects the motor function of the cervical spine.
Mumps- a virus that affects the salivary glands.
Measles– a disease whose symptoms are cough and rash on the skin and mouth.

All other reasons for which the disease develops cannot be predicted or prevented.

The most important thing is that you need to carefully monitor your health, if any symptoms appear, contact a medical facility in a timely manner and never self-medicate without consulting with specialists.

Source: http://neurodoc.ru/bolezni/spinnoy-mozg/mielit.html

Spinal cord myelitis: what it is, features of transverse, acute and other forms, consequences, prognosis, treatment

Most adults suffered from many infectious diseases in childhood: chicken pox, measles, rubella, mumps.

At the present stage of development of medicine, the strategy of using vaccine prophylaxis as an effective method of preventing the above diseases is dominant.

These measures will allow you to avoid many serious complications, one of which is spinal cord myelitis.

1 Definition of the concept
2 Diagnostic methods
3 Treatment program

Definition of the concept

The spinal cord is the second most important outpost of the central nervous system after the brain. The organ is located inside the cavity formed by the vertebrae and consists of a combination of gray and white matter.

The first anatomical formation is a collection of neuron bodies (nerve tissue cells), the second - their processes.

The former are responsible for the movement of skeletal muscles and maintaining their tone, the latter are responsible for conducting an electrical signal (nerve impulse) to the brain and in the opposite direction. A cross section of the spinal cord resembles a butterfly in appearance.

The spinal cord, by analogy with the spine, is divided into a number of sections: cervical, thoracic, lumbar, sacral. In the first and third there are centers for controlling the motor functions of the muscles of the limbs.

Anatomical structure of the spinal cord

Myelitis - medical term, denoting the inflammatory process of the substance of the spinal cord.

The pathology occurs with a frequency of no more than five cases per million population. It is not possible to identify risk groups for the development of myelitis. The process equally often affects people of different genders and ages.

Classification

According to the localization of the inflammatory process, the disease is divided into:
- cervical myelitis, in which the spinal cord is affected at the level of the upper segments. The pathological process inevitably affects the motor and sensory function of the trunk and limbs;
- myelitis of the thoracic region, in which the process affects a large number of middle segments of the spinal cord, which control the motor function of the respiratory muscles and lower extremities;
- lumbar myelitis affects the lower segments responsible for providing control over the muscles of the lower extremities;
- myelitis of the sacral region affects several of the lowest segments responsible for the functioning of the muscles of the pelvic organs - the bladder and rectum;
- mixed myelitis, in which several adjacent parts of the spinal cord are affected (cervicothoracic, thoracolumbar, lumbosacral);
- transverse, in which all components of the spinal cord are affected at a certain level; Sections of the spinal cord
According to the reason that caused the pathological process, myelitis is divided into:
- traumatic, in which the disease begins with mechanical damage to the spine and spinal cord;
- autoimmune, which is based on the damaging effect of one’s own immune mechanisms on the spinal cord tissue;
- infectious, in which the inflammatory process of the spinal cord is based on the pathogenic action of bacteria (causative agents of meningitis, syphilis, tuberculosis) or viruses (causative agents of herpes, intestinal infections, HIV);
- post-radiation, which is based on the pathological effects of radiation (ionizing radiation);
- intoxication, in which toxic substances (medicines, harmful production factors) have a damaging effect on nerve cells;
According to the mechanism of development, myelitis is divided into:
- primary, in which the pathological process begins with damage to the nervous system (meningitis, poliomyelitis);
- secondary, which is a consequence of a pathological process primarily localized in other organs (tuberculosis, syphilis, herpes);
According to the course, myelitis is divided into:
- acute stage, in which symptoms characteristic of other pathologies accompanied by inflammation predominate;
- subacute stage, in which neurological symptoms of spinal cord tissue damage come to the fore;
- chronic stage, the main component of which is residual neurological manifestations of the disease;

Infectious agents are the cause of spinal cord myelitis

Meningococcus - the causative agent of meningitis Treponema pallidum - the causative agent of syphilis Poliovirus - the causative agent of poliomyelitis HIV virus - the causative agent of human acquired immune syndrome Mycobacterium tuberculosis - the causative agent of tuberculosis

Poliomyelitis virus is one of the causes of inflammation of the spinal cord - video

Causes and factors for the development of the disease

The primary link in the development of the inflammatory process is the action of a damaging factor - trauma, infectious, toxic agents, the pathological influence of one's own immune mechanisms.

The consequence is the formation of edema of the spinal cord tissue. An increase in the volume of an organ located in a closed space of the spinal canal triggers a violation of its blood circulation, as well as the formation of small blood clots in the vessels - thrombi.

Lack of blood supply inevitably leads to disruption of the structure of the spinal cord, its softening, and the death of some areas.

In the area where the former focus of inflammation is located, a scar is formed that does not have the specific properties of spinal cord cells, as a result of which a disruption in its functioning is observed.

Predisposing factors include:

severe course of infectious diseases due to lack of vaccination;
presence of foci in the body chronic infection- sinusitis (inflammation of the paranasal sinuses), caries, osteomyelitis (bone inflammation), from which the pathological agent spreads to other organs through the bloodstream;
fractures, bruises of the spine;
operations using spinal anesthesia;
surgical treatment of spinal hernias;

Clinical picture of the disease

In different groups of patients, including pregnant women, newborns and infants, the pathological process in the substance of the spinal cord occurs with a similar clinical picture.

Differences in neurological manifestations in spinal cord myelitis of different localizations

Diagnostic methods

To establish a diagnosis of spinal cord myelitis, the following measures are used:

examination by a neurologist with careful clarification of all the details of the disease;
determination of reflexes, sensitivity, muscle strength and tone, function of the pelvic organs to determine the level of spinal cord damage; Knee reflex diagram
general blood test to detect inflammatory changes;
spinal puncture (spinal puncture) is used to obtain cerebrospinal fluid with subsequent biochemical and microscopic analysis to identify the causative agent of the disease and determine the type of inflammatory process; Spinal puncture (lumbar puncture) is the most important method for diagnosing spinal cord myelitis
determination of antibodies in the blood to identify a specific type of infectious agent in case of bacterial or viral damage to the spinal cord;
a blood test for toxins is used to confirm the appropriate nature of the inflammatory process;
electroneuromyography is used to visualize the passage of a nerve electrical signal through the affected muscles and determine the localization of the source of inflammation; Electroneuromyography is one of the components of the diagnosis of spinal cord myelitis
Magnetic resonance imaging allows you to obtain an image of all segments, identify the level and degree of damage to the brain substance; Tomographic image of the focus of inflammation of the spinal cord

Differential diagnosis is carried out with the following diseases:

Guillain-Barre syndrome;
inflammation of the spinal cord membrane (epiduritis);
malignant neoplasm: primary lesion of the spinal cord or secondary focus (metastasis) of a tumor of another location;
acute circulatory disorder of the spinal cord;

Treatment program

Treatment of myelitis in the acute and subacute stages of the process is carried out in a neurological hospital.

Drug treatment

The following drugs are used in the treatment of myelitis:

antibiotics active against many types of pathogens - Ceftriaxone, Clarithromycin, Azithromycin, Meronem, Tienam;
hormonal drugs for anti-inflammatory and decongestant purposes - Prednisolone, Hydrocortisone;
painkillers - Ketorol, Diclofenac, Analgin;
vitamin therapy: Thiamine, Pyridoxine, Cyanocobalamin;
muscle relaxants for muscle cramps;
uroseptics for the prevention of urinary tract inflammation;

Drugs for treatment

The drug Ceftriaxone is an antibiotic of the cephalosporin group. The drug Meronem is an antibiotic from the carbapenem group. The drug Tienam is a powerful antibiotic with wide range actions

Non-drug treatment and folk remedies

In the chronic stage of the process, the following are used to eliminate residual neurological symptoms:

massotherapy;
physiotherapy;
electrophoresis;
myostimulation; The myostimulation procedure is the main component of physiotherapeutic treatment
magnetic therapy;
acupuncture (acupuncture); Acupuncture - effective method rehabilitation for spinal cord myelitis
Spa treatment;

Folk remedies have not proven their effectiveness, so they are not used for spinal cord myelitis.

Diet

For myelitis, it is necessary to consume foods rich in vitamin B:

wholemeal bread;
legumes;
sea fish;
asparagus;
nuts;
corn;

carbonated drinks;
alcohol;
hot spices;
sausages and smoked meats;
canned food and marinades;

Prognosis and complications

The prognosis for treatment of spinal cord myelitis largely depends on the cause of the disease and the location of the inflammatory process.

With inflammation in the cervical and thoracic spinal cord, the prognosis is serious due to damage to the respiratory muscles.

With the inflammatory process of other localizations, lifelong persistence of varying degrees of severity of neurological symptoms is inevitable. The mortality rate for this disease reaches 30%.

Complications of the disease:

trophic changes in tissues that have been in contact with the surface for a long time (bedsores);
reduction in the mass of affected muscle groups due to impaired nervous regulation;
irreversible damage to the respiratory muscles and lifelong artificial ventilation lungs;
infectious lesion urinary tract due to urinary disorders;

Stories of patients who survived spinal cord myelitis.

Prevention

TO preventive measures relate:

elimination of foci of chronic infection (sinusitis, caries);
vaccine prevention; Vaccine prevention is the main method of preventing spinal cord myelitis
timely treatment of primary infection (tuberculosis, syphilis, HIV);
avoiding contact with toxic substances;

Myelitis of the spinal cord - terrible neurological disease, fraught with the development of dangerous complications. Timely diagnosis and treatment of the pathological process are vital for a favorable prognosis.

Carrying out all necessary measures for vaccine prevention of infectious diseases is the main way to avoid the development of an inflammatory process in the spinal cord, associated complications and subsequent disability.

Elena Timofeeva
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“Keep your back straight,” our parents and teachers taught us since childhood. But the health of the spine lies not only in how we hold it, but also in what condition it is in. You can keep your back straight, but still feel unbearable pain, because...

What is myelitis?

The nervous system consists of two main sections - the central and spinal cord. What is myelitis? This word refers to an inflammatory neurological disease that affects the gray and white matter spinal cord.

Classification:

According to the flow form:

Spicy;
Subacute;
Chronic.

By nature of prevalence:
- Limited – clearly defined focus;
- Diffuse (widespread, disseminated) – inflammation covers the entire spinal cord;
- Multifocal - inflammation is limited, but in many places throughout the spine;
- Transverse – covering several segments in a row.
The pathogens are divided into types:
- Bacterial (infectious);
- Viral;
- Traumatic;
- Post-vaccination;
- Toxic (intoxication);
- Compression;
- Ray;
- Idiopathic (often called autoimmune, neuroallergic) – the cause cannot be determined.
According to the mechanism of occurrence:
- Primary – develops as an independent disease;
- Secondary - develops as a result of another pathology.
According to the source of inflammation:
- Cervical;
- Chest;
- Lumbar.

Causes of spinal cord myelitis

The causes of spinal cord myelitis are divided by type of pathogen:

The bacterial form develops against the background of infection penetration into the spinal cord. This can happen both with a back injury and with the development of an infectious pathology in another organ of the body. A common cause of this form is purulent meningitis, from which meningococcal infection penetrates the spinal cord. Other provocateurs may be treponema pallidum (for syphilis), bacteria that cause typhus, measles, and brucellosis.
The viral form manifests itself in 40% of cases and occurs against the background of damage to the spinal cord substances by Coxsackie viruses, rabies virus, influenza bacteria, etc.
The traumatic form occurs against the background of penetrating, open or closed wounds of the spine, when an infection attaches and penetrates inside. Here the disease develops as an independent disease.
Toxic develops as a result of poisoning of the body with lead, mercury, etc. chemicals. It can occur with the abuse of medications, contaminated food, and alcohol. Often occurs among workers in hazardous industries.
Post-vaccination appears as a result allergic reaction, when a patient is given a vaccine, but the body has a predisposition to reject it.
The radiation form occurs after the patient passes radiation therapy for any malignant tumors and metastases of nearby organs.
The idiopathic transverse form develops for unknown reasons. It is assumed that this is the result of the body attacking itself, which is why the disease develops. It can develop against the background of multiple sclerosis, Devic's opticomyelitis.

Without concomitant factors, the disease may not develop. What are these factors?

Hypothermia or overheating of the body;
Weak immunity;
Stress and overwork;
Infectious diseases of other systems.

Symptoms and signs

Symptoms and signs of inflammation of the spinal cord are divided into stages and forms of progression. However, it all starts with a prodromal period, which is inherent in many infectious diseases (for example, laryngitis, sinusitis, adenitis, etc.):

Weakness;
Pain in muscles and joints;
Malaise;
Sweating:
Temperature increase.

Against the background of these symptoms, other signs develop, which depend on the type of myelitis.

In the acute focal form, the following symptoms are identified:

Back pain and chest, which is inherent in all types of acute forms;
Impaired sensitivity of the lower extremities, which manifests itself in crawling, numbness, tingling;
The numbness intensifies and turns into paralysis of the legs;
Defecation and urination are impaired: delay and complete inability to remove them.

The acute common form manifests itself in the following symptoms:

Asymmetrical sensitivity and mobility on the right and left;
Urination and defecation are slightly disturbed.

Subacute and chronic form expressed in the following characteristics:

Backache - main feature all types of subacute and chronic myelitis;
Impaired sensitivity;
Paralysis of the legs, which is flaccid at first and then becomes pathological;
Problems with urination and defecation;
Formation of bedsores due to impaired circulation and blood supply, tissue nutrition;
Blood poisoning can occur against the background of stagnation of urine and bedsores, which are favorable conditions for the penetration and proliferation of infection.

The radiation form may appear 2 years after irradiation with symptoms characteristic of the affected area. Most often, the lower extremities are affected, which lose sensitivity and tingling and crawling begin.

Impaired sensitivity of the lower extremities consists of a decrease in the pain threshold, temperature perception and the inability to determine how the legs lie if you close your eyes. The opposite effect may occur when sensitivity increases.

Myelitis manifests itself in characteristic stages:

The acute stage is an increase in the symptoms of myelitis and lasts up to 3 weeks.
Early recovery stage – stabilization of well-being and duration of up to 5 weeks. A decrease in disturbances in sensitivity and functioning of the small pelvis becomes characteristic, and bedsores also close.
Late recovery stage.
Residual effects (recovery stage).

Myelitis in children

Myelitis in children occurs for the same reasons as in adults. An untreated inflammatory or infectious disease (especially in the brain) can spread to the spinal region. Manifests itself in increased temperature, swelling of the legs and drowsiness. It is recommended to immediately contact your pediatrician for examination and treatment.

Myelitis in adults

Myelitis in adults is observed in both women and men. Women more often suffer from psycho-emotional instability, which allows penetrating infections to provoke illness. Men suffer due to neglect of their own health, as well as due to working in hazardous industries.

Diagnostics

Diagnosis of spinal cord myelitis begins with the patient contacting a doctor for reasons of general intoxication and the appearance of the first signs of paralysis. The doctor collects complaints and makes general examination, which is supplemented by the following procedures:

Cerebrospinal fluid puncture;
Analysis of cerebrospinal fluid for inflammation and infection;
Blood analysis;
MRI or tomography using contrast;
Suboccipital myelography;
Tests for the detection of other pathogens;
Assessment of strength in the limbs;
Electroneuromyography;
Consultations with a surgeon.

Treatment

Treatment of spinal cord inflammation is carried out in a hospital setting and providing rest. If folk remedies are used, it is only as a additional methods, which soothe and reduce symptoms, but do not cure the disease.

How to treat myelitis? Medicines:

Hormonal medications: prednisolone, glucocorticoids.
Antibiotics, even if bacteria and viruses are not detected in the cerebrospinal fluid. The reception is carried out in order to prevent the penetration of infection into the affected area. Also prescribed antiviral drugs in case of damage to the spinal cord by viruses.
Diuretics: Furosemide, Mannitol, etc.
Narcotic and non-narcotic analgesics.
Antipyretics (antipyretics).
Anticholinesterase drugs to improve bowel movements.
Anti-inflammatory drugs.
Vitamins.
Painkillers.
Muscle relaxants for muscle spasms.

How else is myelitis treated?

Physiotherapeutic procedures:

Massage the lower extremities and those places where bedsores form;
Physical therapy in bed;
Massage with tetracycline or penicillin ointment;
Acupuncture;
Bladder catheterization or epicystostomy.

Although folk remedies do not cure the disease, they help reduce unpleasant symptoms at home:

Boil the potatoes, mash them, add the same amount of honey, make a flat cake. Place it on your neck and cover with cling film. When the cake has cooled, change it to another.
Add a little propolis and vodka to aloe juice and dry mustard (taken in equal proportions). Make a mixture that resembles plasticine. Place on the neck and cover with cling film, preferably overnight.

The patient's menu should be balanced, full of vitamins and proteins.

Life forecast

How long do people live with myelitis? The disease is not considered fatal, but worsens the prognosis of life due to its complications that arise. The most important complication that can occur in case of improper or lack of treatment is paralysis of the lower extremities (observed in 30% of cases). Also, sepsis should not be ruled out - the spread of infection to other organs through the blood.

How can myelitis develop?

Favorable option: acute myelitis enters the stabilization stage, the symptoms gradually subside and the patient recovers.
Satisfactory option: transverse myelitis accompanies the patient throughout his life, without leading to deterioration of health.
Unfavorable option: the infection spreads up the spinal cord and penetrates into the brain stem.

You should resort to preventive measures that will help heal and prevent the recurrence of inflammation of the spinal cord:

Treat infectious diseases other organs, which often provoke other inflammatory processes in organism.
Do physical exercises.
Monitor the health of the spine, for example, keep it straight and not expose it to damage.
Consult a doctor when the first symptoms appear.

Myelitis is a spinal pathology that primarily affects one or two segments of the organ and is inflammatory and infectious in nature.

Myelitis - description of the disease

The pathogen and/or its toxins penetrate the spinal cord and provoke inflammation in the latter. In this case, the bodies and processes of nerve cells are affected, the membranes, nerve trunks and roots can be damaged.

In neurology, there are several types of spinal cord myelitis, each of which has its own symptoms, severity of manifestations and prognosis.

For example, neuromyelitis optica (neuromyelitis optica, Devic's disease (syndrome)) is not typical for childhood, and if it develops in children, then, unlike adults, it is relapse-free, single-phase, and also has a favorable prognosis.

On the other hand, before mass vaccination in children, much more often than in adults, a pathology such as polio, provoked by a special virus and having a high probability of fatal outcome and disability.

A significant role in the development of secondary myelitis pathology in children is played by diseases common at this age: measles, whooping cough, chickenpox and others.

Types of disease

Myelitis can be an independent primary pathology when it is caused by viruses that selectively infect neurons.

If the pathology was the result of another infectious process, which is more common, it is called secondary myelitis.

Depending on the intensity of the development of symptoms, the form of the disease is:

chronic course;
acute;
subacute course.

Myelitis is classified according to location:

limited? focal nature of the disease;
multifocal (scattered, disseminated) – foci at different levels;
transverse - several spinal segments are covered, which are located next to each other;
widespread (diffuse) – affected in varying degrees the entire spinal cord.

Are the cervicothoracic and thoracic spinal regions affected more often or less often? cervical (cervical myelitis), lumbar.

Accordingly, the name of the diagnosis may indicate several characteristics. Thus, the term “acute transverse myelitis” corresponds to an inflammatory lesion of a number of spinal segments with an intense, bright course.

Separate form? neuromyelitis optica, when, in addition to the standard symptoms of pathology, there are visual disturbances and complete loss of vision may occur.

Reasons for the development of myelitis

Purulent myelitis? This bacterial infection, most often provoked by meningococcus.

Almost 40% of cases of the disease are caused by viral forms of the disease, caused by Coxsackie viruses, influenza, rabies and others.

Traumatic myelitis? a consequence of spinal injury with subsequent complications.

Result of poisoning chemical compounds(lead, mercury, etc.) ? toxic myelitis, which often also affects nerves and nerve roots.

Has an allergic nature post-vaccination myelitis, which develops after vaccination in the presence of a certain predisposition (including VAP (vaccine-associated polio) when using the oral form of the vaccine).

Radiation therapy for cancer of the pharynx, larynx, esophagus, etc. may provoke development radiation myelitis.

In cases where it is impossible to establish the cause of the pathology, they speak of idiopathic myelitis. It is assumed that the main factor in the development of such episodes is a failure of the immune system.

Contributing factors:

weakness of the immune system;
hypothermia.

Symptoms and signs of spinal myelitis

The myelitic process consists of conditional stages:

acute manifestations;
early recovery (lasts about six months from the moment the condition stabilizes);
late recovery (up to two years);
residual manifestations (after two years).

Symptoms of primary myelitis vary as follows:

first, there is a prodromal period (two to three days) with flu-like symptoms (muscle pain, general poor health, fever, etc.);
then tingling, “goosebumps” in the limbs, and girdle pain appear;
as pain decreases, signs of spinal damage increase (weakness in the legs, decreased sensitivity, abdominal tension, flatulence, difficulty defecating and urinating);
then there is a rapid development of trophic ulcers and bedsores (almost regardless of the quality of patient care).

A similar picture can develop in a couple of minutes, but there is also a gradual increase in symptoms over the course of a month or even longer.

The most difficult current? in lower thoracic, lumbosacral, cervical myelitis.

Signs of secondary myelitis may appear at the peak of the underlying illness or during recovery. So, with chickenpox, the deterioration of the condition due to myelitis can occur on the 3rd - 5th day, with measles - on the 5th? 7th.

In a chronic primary process, myelitis can develop at any stage. Secondary myelitis has a subacute course and negative manifestations increase over the course of weeks.

Features of manifestation for different species

Symptoms acute transverse myelitis with stroke-like development, they are characterized by decreased muscle tone (lethargy) for a couple of weeks. If the disease does not progress quickly, then dysfunction of the pelvic organs occurs later.

Acute focal myelitis:

mild pain appears in the back and chest with a general deterioration in health;
sensitivity in the legs is impaired, numbness, tingling, and “goosebumps” are felt;
urinary and/or fecal incontinence or difficulty defecating and/or urinating develop.

Acute widespread myelitis is characterized by:

unevenness of symptoms with different sides bodies;
minor dysfunctions of the pelvic organs.

The chronic, like the subacute, form has the following features:

mild back pain due to poor general health;
development of pathological processes below the localization of lesions;
impaired sensitivity and functions of the pelvis, paralysis;
mild paralysis at the onset of the disease and its subsequent progression to a spasmodic state;
disruption of nutrition and blood supply to tissues with the formation of bedsores;
addition of bacterial infection, blood poisoning.

For radiation myelitis:

the first signs are observed after 6 - 48 months from the moment of irradiation;
the symptomatic type depends on the location of the lesion;
The functions of the limbs are predominantly impaired.

Diagnostics

The presence of signs of spinal pathology on a general intoxication background.
Puncture and study of the cerebrospinal fluid for the presence of pathogens and inflammatory elements.
Myelography.
CT, .

Differential diagnosis

Myelitis is differentiated from:

traumatic compression of the spinal cord;
metastatic lesions of the spine;
spinal stroke and/or arachnoiditis;
polyneuropathy;
epiduritis, etc.

Toxic polyneuritis, although not a very common disease, is quite dangerous. Its main symptoms are described in detail in the section that you will find by following the link.

Treatment

Myelitis is treated in a hospital setting.

Drug therapy

Reception includes:

antibacterial agents;
glucocorticosteroids (prednisolone in a daily dosage of up to 120 g) for viral, allergic and idiopathic forms;
adrenocorticotropic hormones;
potassium orotate;
anticholinesterase drugs, often together with muscle relaxants for increased tone;
diuretics (furosemide, etc.);
antipyretics in case of fever;
analgesics (non-narcotic, narcotic);
glucose with methenamine.

For paralysis resulting from increased tone, thermal procedures (baths, paraffin, etc.) are indicated; for flaccid paralysis, electrical stimulation is indicated.

Therapeutic techniques

detoxification;
dehydration;
ensuring constant emptying of the bladder;
prevention of bedsores;
Ventilation for respiratory muscle paralysis;
orthopedic styling.

At the end of the acute stage:

vitamin therapy (can also be prescribed in the acute period);
physiotherapy (UHF can also be used at the onset of the disease);
massage;
exercise therapy complexes;
treatment in sanatoriums and resorts.

Surgery

At the last stage of the disease, with severe motor disturbances due to high tone, a neurosurgical operation can be performed.

At the acute stage, surgical therapy is implemented for:

the presence of purulent foci;
significant manifestations caused by compression of the spinal cord.

Unconventional methods of treating myelitis

Treatment of myelitis with folk remedies is carried out after consultation with a doctor and includes compresses:

from potatoes with honey;
on the neck from a mixture of vodka, mustard, aloe, propolis.

Homeopathic treatment is carried out by a specialist in this field based on the observed manifestations (prescriptions are adjusted as symptoms change) and the characteristics of the patient. Episodes of use of Piricum acidum, Lathyrus sativus, Alumina in the required dilution for myelitis are described.

TO unconventional methods Treatment of myelitis also includes hirudotherapy.

The video shows what leeches treat and how a hirudotherapy session will help:

Prognosis and recovery after illness

Myelitis can develop with:

stabilization and gradual reduction of symptoms;
persistence of manifestations for life without worsening (typical of acute transverse myelitis);
progression of pathology, spread of inflammation to the lower part of the brain.

Myelitis of the lower thoracic and lumbosacral (due to disorders of the pelvic functions), as well as cervical (due to the proximity of the muscles responsible for breathing, etc.) has a poor prognosis.

Purulent myelitis often ends in death.

Consequences and preventive measures

Expressed spinal injury at purulent forms the disease leads to paralysis of the arms and/or legs.

Even after a mild course of the pathology, sensory disturbances, leg cramps, and problems with motor actions persist.

Frequent complications of myelitis include the formation of bedsores and impaired mobility of the joints of the injured limb.

Prevention

Specific measures are aimed at preventing secondary myelitis and include vaccination against:

measles;
polio;
chicken pox;
mumps, etc.

Myelitis poses a serious threat to the patient's restoration of normal activity and life. Emergency Adoption therapeutic measures increases the likelihood of a positive outcome. Vaccinal prevention of a number of childhood diseases significantly reduces the risk of secondary infectious myelitis.