Study of acute transverse myelitis using CT and MR imaging

Myelopathy of the cervical spine

This pathology represents spinal injuries of various etiologies. Anomalies appear in a complex and are chronic non-inflammatory processes in the structures of the spinal cord. The disease can occur in any part, but in the vast majority of episodes it is localized in the cervical vertebral area. The second most common location is the lumbar area. This disease is not classified as a separate disease. Rather, it is a collective pathology that illustrates a malfunction of any of the spinal regions. The reasons for its occurrence are different and varied, as are its manifestations.

Occurrence and characteristics of myelopathy

As already noted, the process is chronic. This means that sudden spinal cord problems cannot be called myelopathy. Usually, when degenerative processes start in the spinal column, myelopathy gradually arises, gradually acquiring and manifesting new symptoms.

There are a number of factors that can dramatically increase the formation of myelopathic pathology. These include:

• multiple sclerosis;
• autoimmune neuromyelitis;
• infections;
• carrying out radiation therapy;
• injuries during sports or other activities;
• reaching old age.

By the way. The spinal cord is an important organ of the human nervous system. It is hidden in the canal, which consists of the vertebral bodies and their processes. The work of the brain is associated with numerous functions, including muscle reflexes, since all nerve impulses to the brain of the head pass through it. Myelopathy leads to compression of the spinal cord.

Why does neck myelopathy develop?

The cervical vertebral zone has connections with almost all the most important organs and systems. Anomalies in it can cause a number of diseases and pathological conditions.

1. Degenerative changes in the structural tissues of the intervertebral discs, narrowing the medullary canal.
2. Progressive osteoporosis.
3. Direct injuries to this spinal area.
4. Presence of osteochondrosis.

Diagnosis and symptoms

Compression of the brain body leads to the formation of numerous symptoms that the patient feels with myelopathy.

1. Muscle weakness. It is difficult to lift and move objects, everything falls out of your hands.
2. Sensitivity is impaired and numbness of the limbs occurs, accompanied by tingling.
3. Tactility decreases, as does sensitivity to temperature.
4. Pain appears and intensifies in the cervical and occipital areas, as well as the interscapular region.
5. Fine motor skills suffer.
6. The muscles begin to twitch involuntarily.
7. Spatial coordination deteriorates.

Diagnosis of the disease begins with a thorough medical examination and ends with radiological diagnosis of the cervical area. The reflex response, skin sensitivity, and muscle contraction are checked.

Reflex testing helps identify increases in the strength of the reflex response. Muscle contractions occur uncontrollably, spasmodically. In addition, arms and legs become numb, and skin sensitivity decreases.

By the way. With a long course of the disease without receiving adequate effective treatment, a person can come to complete muscle atrophy and a lack of connections between the nerves and the muscular system.

The following diagnostic techniques are used.

1. Myelography.
2. Radiography.
3. Magnetic resonance examination.
4. CT scan.
5. Radiation diagnostic study.

The X-ray technique allows you to detect myelopathy in the middle stages. Using X-rays, a full assessment of the condition of all spinal segments is carried out. MRI and partially CT detect the disease even in a stage that has not developed to a pathological state. As for the myelography procedure, this is a contrast X-ray in which a foreign substance is poured into the spinal cord, and after that a contrast CT scan is performed. It allows you to detect a tumor formation, if present. The contrast will also show intervertebral hernia, areas that have pathologically narrowed, and will help determine the degree of development of the pathology.

If you want to know in more detail the indications and procedure for MRI of the cervical spine, you can read an article about this on our portal.

Clinical picture of myelitis

You need to be wary if you see the following symptoms in your cat or dog:

• The pet has difficulty getting up, and its movements resemble the “grace” of a seriously drunk person.

• Pathological behavior. Sometimes a dog or cat turns into “mattresses” who absolutely don’t give a damn about what’s happening to them, and sometimes the animal awakens to unmotivated aggression, which it can even show towards its own owner or members of his family.

• Dilated or constricted pupils, “inappropriate” to the nature of the lighting. Simply put, in complete darkness your pet may have pupils the diameter of a pinhead, but in the light they expand, taking up most of the eyeball. Because of this, you may notice that the pet is blind, like a mole, and therefore bumps into furniture and people.

• A characteristic sign of myelitis is constant constipation or spontaneous bowel movements/urination.

• The animal is physically unable to swallow food.

• In severe cases, you may notice that your pet does not feel pain at all: if you poke him in the paw with a needle, no reaction will follow.

• Intermittent fever.

Good afternoon.
I have a dachshund, 8 years old. At the beginning of the year, we noticed that he was jumping on the bed less often and climbing the stairs more slowly. But they thought it was just age taking its toll. However, at the end of March, he began dragging his hind legs and we immediately went to Biocontrol. The preliminary diagnosis was grade 1-2 discopathy. They prescribed metypred, etc. They did an MRI, but the discopathy was not confirmed; signs of myelitis and small protrusions between the vertebrae were found. The dog was getting worse and worse; he had a myelogram (the dog almost went blind after it) and a second MRI did not detect discopathy. Biocontrol didn't help us with anything else. Then we turned to the Veterinary Academy (Scriabin). There they again prescribed various drugs (Actovegin, Neuromedin, etc.) - it did not help. They sent me again for an MRI - the diagnosis was the same - myelitis, but on most of the spine. We were offered to operate on him (out of despair), which is what we did. But no hernias, tumors, pus, etc. were found. Inflammation of the spinal cord of unknown origin. By this time, the dog’s hind legs had completely given up. We were prescribed Cobactan, Zantac, etc. But after the operation the dog became ill - heart failure, pulmonary edema. They took me to the nearest clinic (Univet) and pumped me out under oxygen. But a terrible wound appeared on the hind paw (either the medicine from the catheter got under the skin, or it was chewed by itself - unknown). We have been treating the paw for three weeks now - 1-2 times a day, bandaging it. The wound is healing, but the hind legs have completely failed (however, pain sensitivity has remained). The dog is in a depressed mood, but his appetite is good. We no longer expect him to start running, but maybe we can somehow improve his condition. We won’t cut and stab him anymore, but maybe we can give him supporting, stimulating drugs? Special massage? Homeopathy? Physiotherapy? Please advise!!! Myelitis, what is it?

Description of species

Since the pathology is multifaceted, there are several types into which the disease is usually divided.

Table. Types of myelopathy and their characteristics.

If at the beginning of the disease the clinical symptoms are mild, then gradually the affected area of ​​the neck begins to experience more and more pain, which is not relieved by analgesic drugs. This characterizes any form of manifestation. Also obligatory are numbness (numbness) and weakening of the limbs, convulsive spasms, poor tactility and coordination. Perhaps, especially in the metabolic form, there may be a malfunction of the gastrointestinal tract, sweating, and urinary dysfunction. With a complicated course, the patient may experience paresis and paralysis.

How is myelopathy treated?

In order to successfully cure a patient of myelopathy, it is necessary to eliminate the cause of this pathology that provoked this disease. The result can be achieved if you use a whole range of medications.

Nonsteroids

The first in the group are non-steroidal anti-inflammatory substances, which are characterized by a combined effect that relieves inflammation, swelling, heat and pain at the same time. Thanks to NSAID therapy, the patient's condition begins to improve almost immediately. Basically, NSAIDs are used in the treatment of myelopathy:

As for dosage forms, their choice is made by the doctor depending on the strength and severity, as well as the duration of the pain syndrome.

This may be an ointment, gel, or other creamy substance applied topically. Or, what happens most often, is the tablet form. In acute forms, when a quick anti-pain effect is required, or when there are contraindications to ingesting tablets (for example, damage to the gastrointestinal tract or esophagus), an injection form is prescribed. In the acute stage, when the pain is difficult to bear, injections are usually given. A few days later, after the patient’s condition has stabilized, they switch to continuous oral administration of tablet forms.

Important! Long-term use of non-steroids can lead to complications of existing gastrointestinal diseases or to the formation of these pathologies. It is necessary to strictly adhere to medical recommendations and not exceed the duration of the therapeutic course.

Glucocorticosteroids

Drugs belonging to this group play “second fiddle” in the treatment of myelopathy. They are used when there is no expected positive effect from non-steroids, or if their use for some reason must be stopped until cure.

By the way. Glucocorticosteroids are always present in a therapeutic regimen with caution, since these drugs have many more contraindications and conditions for use than NSAIDs.

Glucocorticosteroid drugs include:

These drugs are hormonal in nature, therefore, when administering them, preference is given to the injection method, and paravertebral, so that the drug immediately affects the painful area without affecting the entire body.

Metabolism boosters

Thanks to the intake of these drugs, metabolic processes are activated and the level of hypoxia progression is reduced, which is important in the treatment of myelopathy.

Antibacterial drugs

Medications from a wide list of antibacterial substances are used if cervical myelopathy has an infectious etiology. Before the appointment, a bacteriological examination is carried out, taking a bacterial culture from the pathological focus. In this way, the infectious pathogen is determined and the degree of its sensitivity to the prescribed drug is established.

By the way. If a bacteriological puncture cannot be performed for any reason, broad-spectrum antibiotic drugs are prescribed.

Muscle relaxants

This group is needed to relieve muscle spasms, which will also reduce pain. The therapy will lead to increased mobility of the cervical spinal area, which will make the patient feel better. Muscle relaxants recommended for use in myelopathy include:

Neuroprotectors

When the channels are compressed and the spinal cord is clamped, blood flow always suffers and the oxygen supply is disrupted. Neuroprotectors help activate blood circulation and normalize the delivery of oxygen, along with other nutritional components, to the brain. Basically, the drugs prescribed are:

Vasodilators

These drugs, like neuroprotectors, help restore normal blood flow in the vessels. They relieve vascular spasm and, accordingly, the pain syndrome arising from it. Popular vascular dilators include:

Vitamins

Taking vitamins will help strengthen the body in the fight against disease and increase its protective capabilities. Especially in case of vertebral pathologies, it is important to take sufficient quantities of B-group vitamins.

Other treatments

Rather, they can be classified as additional, which are, nevertheless, mandatory. Treatment for cervical myelopathy includes:

• wearing a collar corset (Shants collar);
• physiotherapeutic treatment;
• massage complex;
• exercise therapy;
• acupuncture.

If the case of pathology is severe or takes an uncontrolled acute form, due to not receiving timely treatment, surgery may be prescribed. Most often, myelopathy is operated on for compression forms that arise as a result of injury.

If you want to learn in more detail how to treat exacerbation of cervical osteochondrosis, as well as consider symptoms and alternative treatment methods, you can read an article about this on our portal.

Video - Myelopathy of the cervical spine

Video - Myelopathy

Myelitis

Myelitis

– a general name for any inflammatory processes of the spinal cord. Symptoms directly depend on the level and extent of the lesion; most often it is pain (its irradiation), paralysis, pelvic dysfunction, sensory disturbance and others. Diagnosis of myelitis includes a neurological examination and assessment of the parameters of cerebrospinal fluid taken for analysis by lumbar puncture. CT or MRI of the spinal cord and myelography may also be prescribed. Treatment includes the prescription of antibiotics, anti-inflammatory drugs, analgesics, muscle relaxants, as well as exercise therapy, massage and physiotherapeutic procedures.

General information

Myelitis is the general name for all inflammations of the spinal cord that can affect both gray and white matter. That is, myelitis is any spinal inflammatory process. Depending on the form and extent of inflammation, the severity of symptoms can vary significantly, but the disease still remains quite severe. Myelitis has a high rate of complications and is difficult to treat. This disease can hardly be called widespread; it occurs in no more than 5 cases per 1 million people.

It is impossible to identify any features in the structure of the incidence of myelitis; gender or age have virtually no effect on the risk of developing the disease. Some researchers provide evidence that myelitis most often affects people aged 10 to 20 years and the elderly.

Symptoms of polio

According to WHO, polio mainly affects children under 5 years of age. The incubation period lasts from 5 to 35 days, symptoms depend on the form of polio. According to statistics, most often the disease occurs without impairment of motor functions - for every one paralytic case there are ten non-paralytic ones. The initial form of the disease is the preparalytic form (non-paralytic poliomyelitis). It is characterized by the following symptoms:

1. General malaise;
2. Temperature increase up to 40°C;
3. Decreased appetite;
4. Nausea;
5. Vomit;
6. Muscle pain;
7. Sore throat;
8. Headache.

The listed symptoms gradually disappear within one to two weeks, but in some cases they can last longer. As a result of headache and fever, symptoms arise that indicate damage to the nervous system.

In this case, the patient becomes more irritable and restless, and emotional lability is observed (mood instability, constant change). Muscle rigidity (that is, numbness) also occurs in the back and neck, and Kernig-Brudzinski signs appear, indicating the active development of meningitis. In the future, the listed symptoms of the preparalytic form may develop into the paralytic form.

Causes of myelitis

Sometimes it is not possible to accurately establish the cause of the development of myelitis, but in most cases, the main “trigger factors” are still known. The only classification of myelitis used in clinical neurology is based precisely on etiology, that is, the cause of its occurrence. According to this classification, three variants of the disease are distinguished: infectious, traumatic and intoxication.

Infectious myelitis

. Accounts for almost half of all cases. This type, in turn, is divided into two groups: primary (if the infection initially penetrated only into the spinal cord) and secondary (if inflammation occurred after infection penetrated the spinal cord from other foci). The causes of infectious myelitis most often include: herpes simplex virus types I and II, cytomegalovirus infection, mycoplasmas, syphilis, HIV, enterovirus infections. Somewhat less frequently, the etiological factor may be meningococcal infection and borellosis. Secondary infectious myelitis occurs mainly with osteomyelitis of the spine and when infection is carried through the blood.

Traumatic, intoxication and other types of myelitis

. Intoxication myelitis occurs under the influence of poisons that are tropic to the cells of the spinal cord. Such inflammation can occur both during acute poisoning (for example, with a number of drugs and psychotropic drugs) and during chronic exposure to a toxic substance (most often this concerns hazardous production).

Myelitis resulting from spinal trauma has two components. Firstly, direct mechanical impact on the spinal cord inevitably leads to disruption of its functions. Secondly, when injured, microorganisms can enter the spinal cord through the wound. In addition, spinal inflammation can be caused by certain systemic diseases. Most often, myelitis can be found against the background of multiple sclerosis (in this case, myelitis can rightfully be called a symptom of the underlying disease), a number of autoimmune diseases and vasculitis. Myelitis also often develops as a component of paraneoplastic syndrome, which occurs in the early stages of malignant tumor growth.

Paralytic polio

It develops quite rarely, but, as a rule, leads to disruption of many body functions and, accordingly, to disability:

• Bulbarnaya. Particularly serious is the development of bulbar palsy. The entire group of caudal nerves is affected. Selective damage to one or two nerves is not typical for polio. If the reticular formation, respiratory and vascular centers are damaged, consciousness and respiratory disorders of central origin may be impaired.
• Pontina. This type of polio is characterized by the development of paresis and paralysis of the facial nerve, in which partial or complete loss of facial movements occurs.
• Encephalitic. The brain substance and subcortical nuclei are affected (very rarely). Central paresis, convulsive syndrome, aphasia, and hyperkinesis develop.
• Spinal. Weakness and muscle pain are gradually replaced by paralysis, both general and partial. Muscle damage in this form of polio can be symmetrical, but paralysis of individual muscle groups throughout the body occurs.

There are 4 periods during the course of the disease:

• preparalytic;
• paralytic;
• restorative;
• residual.

Pathogenesis

A precipitating factor - be it an infection or injury - causes swelling of the spinal cord. This can be considered the starting point from which the entire pathological process begins. Edema disrupts blood circulation in the tissues, and vascular blood clots occur. This in turn increases swelling. The mechanism of development of myelitis follows the so-called “vicious circle”, which is so characteristic of many neurological diseases. A circulatory disorder (or even its cessation in certain areas) ultimately causes softening and necrosis of the spinal cord tissue.

After recovery, the site of necrosis is filled with connective tissue - a scar is formed. Of course, scar tissue cannot perform the functions inherent in nerve cells, so many disorders that occur during illness can persist after recovery. Pathomorphologically, the substance of the spinal cord looks swollen and flabby; the characteristic “butterfly” has unclear outlines. Microscopy reveals areas of hemorrhage, edema, myelin breakdown, and an infiltrative process.

Signs of pathologies with similar manifestations

Disseminated encephalomyelitis

• Asymmetric neurological disorders, mainly with sensory impairment
• Oligoclonal Ig in CSF (also in acute disseminated encephalomyelitis)
• Eccentric signal enhancement from spinal cord white matter
• The lesion extends to more than two segments; multiple lesions
• Accumulation of contrast in the affected area during periods of exacerbation

Spinal cord infarction

• Predominant damage to the gray matter of the spinal cord
• Usually in the anterior parts of the spinal cord, in the basin of the anterior spinal artery

Intramedullary tumors (such as astrocytoma)

• Uneven increase in signal intensity (T2-weighted image)
• Complete transverse spinal cord lesion
• RBC breakdown products (increased signal intensity on T1-weighted image)
• Lack of alternation of healthy and affected areas
• Significant uneven increase in signal intensity after contrast

Symptoms of myelitis

The clinical picture of myelitis depends entirely on the location of the inflammation. The level of damage is determined by segments or sections of the spinal cord (each of which has several segments). For example, myelitis can be thoracic, upper cervical, lumbar, etc. As a rule, myelitis covers the entire diameter of the spinal cord segment, disrupting the functioning of all conduction systems. This means that both spheres are disrupted: motor and sensitive.

It is worth describing the symptoms of myelitis taking into account the time of their onset. From the onset of the disease to its peak, the clinical manifestations of the disease change markedly. The first signs of infectious myelitis are completely nonspecific and differ little from other infectious diseases. An acute onset, a sharp increase in body temperature to 38-39˚C, chills, weakness - all “standard” signs of any inflammatory process. Then the disease begins to acquire its characteristic features. The first neurological symptom is usually back pain. It can be very intense (this varies from person to person). Pain in myelitis is not localized in one area: the pain spreads to neighboring areas of the body. Its irradiation (actually, the spread of pain) is a sign of damage to the roots of the spinal cord (radiculitis). The pain can “radiate” to the back, perineum, hips, etc. It all depends on the level of the lesion. Symptoms become more severe over time, and in some cases this “evolution of symptoms” can occur over a period of hours or days.

As already mentioned, the clinical picture of myelitis varies depending on the level of inflammation. Myelitis of the upper segments of the cervical spinal cord is characterized by spastic tetraparesis. It is the most dangerous: there is always a possibility of damage to the phrenic nerve. This, in turn, threatens to stop breathing. The spread of inflammation from the upper cervical segments upward to the structures of the medulla oblongata can lead to bulbar disorders. Myelitis at the level of the cervical thickening is manifested by a combination of flaccid paresis of the arms with spastic paresis of the legs. The lower segments of the cervical spine are affected more often than the upper ones, and their inflammation is not as dangerous. In some cases, it threatens with persistent motor impairments (myelitis of this localization, as a rule, is not life-threatening).

The thoracic region of the spinal cord is perhaps most often affected. Damage to this area causes the development of spastic paralysis of the legs. The latter is tension paralysis. At the same time, the muscles acquire excessive tone, and cramps may appear. The response to testing the knee and Achilles reflexes in thoracic myelitis is always too active. It is worth remembering that with rapidly developing transverse myelitis, decreased muscle tone may first be observed, then, after some time, the disorders acquire the character of spastic paralysis.

The lumbosacral spinal cord is also often affected by myelitis. Symptoms of myelitis of this localization include peripheral paresis in the legs and disorder of pelvic functions such as urinary and fecal incontinence. In parallel with this, the muscles that are innervated by the affected nerves, deprived of normal regulation and nutrition, gradually atrophy.

Sensory disturbances are observed in any type of myelitis. The only unshakable rule: this kind of disorder always occurs below the site of the lesion. Sensitive disorders consist of a decrease or complete absence of pain sensitivity, a decreased reaction to touch, cold, etc. Paresthesia may occur - “non-existent sensations”, for example, “goosebumps”, cold or the feeling of wind.

Preparalytic stage

It is characterized by a rather acute onset, high body temperature, general malaise, headache, gastrointestinal disorders, rhinitis, pharyngitis. This clinical picture persists for 3 days, then the condition normalizes for 2-4 days. Afterwards there comes a sharp deterioration in the condition with the same symptoms, but more pronounced intensity. The following signs are included:

• pain in legs, arms, back;
• decreased reflexes;
• increased sensitivity;
• decreased muscle strength;
• convulsions;
• confusion;
• excessive sweating;
• spots on the skin;
• "goose pimples".

Diagnostics

There are no non-traumatic methods for diagnosing myelitis (of course, if you need to establish the exact cause and not a preliminary diagnosis). The most complete information is provided by a lumbar puncture. In acute cases, CT or MRI of the spine and myelography are prescribed.

As a rule, medical history, knowledge of symptoms and results of cerebrospinal fluid analysis are quite sufficient for an accurate diagnosis. Liquor puncture also makes it possible to carry out differential diagnosis, that is, to clarify the diagnosis by comparing the data obtained with the signs of clinically similar diseases. Myelitis must be differentiated from Guillain-Barré syndrome, hematomyelia, epiduritis, tumors and acute circulatory disorders of the spinal cord.

Treatment of myelitis

When choosing treatment, a neurologist must rely on information about the possible cause of the disease and the characteristics of the development of myelitis in a given patient. In all cases, for myelitis, broad-spectrum antibiotics are prescribed (usually antibiotics must be taken in large doses), anti-inflammatory drugs (almost always glucocorticoids), analgesics, and antipyretic drugs. If necessary (based on the patient’s condition), muscle relaxants and uroseptics can be prescribed. For urinary retention, anticholinesterase drugs, bladder catheterization and rinsing with antiseptics are used.

Of great importance in the treatment of myelitis and its consequences is physical therapy (during bed rest - in bed, and later - in the hall or ward), massage (percussion) and physiotherapy. To restore the function of damaged nerve cells (as far as possible), it is necessary to use vitamin preparations (group B). It is desirable that these are injectables. In order to prevent bedsores, various devices (cotton swabs, a circle) are placed under the sacrum and other bony protrusions, the position of the body is changed, and the skin is wiped with camphor alcohol or a soap-alcohol solution. For the same purpose, UV irradiation is prescribed for the sacro-gluteal and ankle areas.

Prognosis and prevention

The prognosis for myelitis, again, depends on the level and extent of the lesion. Upper cervical myelitis often causes death in patients; lumbar and thoracic (without timely treatment) are highly likely to lead to disability. With a favorable course of the disease, recovery occurs in 2-3 months, and full recovery occurs in 1-2 years. During this period, it is recommended: sanatorium-resort treatment (if it is prescribed correctly, the duration of recovery will be significantly reduced), vitamin therapy, prevention of bedsores, physiotherapeutic procedures (UVR), physical therapy, and the prescription of anticholinesterase drugs.

Taking into account the number of causative factors in the development of myelitis, there cannot be specific prevention of this disease by definition. To some extent, vaccination helps prevent the disease. Nonspecific prevention of myelitis includes timely elimination of chronic foci of infection in the body (for example, sinusitis or caries).

source

Vaccination against polio

Specific prevention is vaccination against polio. There are 2 types of polio vaccines:

• Sebin live vaccine (OPV - contains live attenuated viruses)
• inactivated (IPV - contains polioviruses of all three serotypes killed by formaldehyde).

Currently, the only manufacturer of polio vaccine in Russia is the Federal State Unitary Enterprise “Enterprise for the production of bacterial and viral preparations of the Institute of Poliomyelitis and Viral Encephalitis named after. M.P. Chumakova produces only live polio vaccines.

Other drugs for vaccination are traditionally purchased abroad. However, in February 2020, the company presented the first samples of an inactivated vaccine of its own development. The start of its use is planned for 2020.

Myelitis of the spinal cord

Spinal cord myelitis is a general name for all inflammatory diseases affecting the spinal cord. Myelitis can develop due to an allergic or infectious lesion. Often the pathological process spreads to several (1-2) segments of the patient’s spinal cord, but there are cases when their number increases under the influence of certain factors. The disease is accompanied by many symptoms, the main of which is disruption of the spinal cord. If the patient is not provided with timely assistance, myelitis can result in serious complications.

Post-polio syndrome

After suffering from polio, some patients continue to have limited capabilities and a number of manifestations for many years (on average 35 years), the most common of which are:

• progressive muscle weakness and pain;
• general weakness and fatigue after minimal exertion;
• amyotrophy;
• breathing and swallowing disorders;
• breathing disorders during sleep, especially sleep apnea;
• poor tolerance to low temperatures;
• cognitive impairment - such as decreased concentration and difficulty remembering;
• depression or mood swings.

Causes

Infection is one of the most common factors that can cause myelitis. These can be encephalitis ticks, fungi, pathogenic microorganisms (spirochetes, meningococci, etc.), HIV, herpes or rabies viruses. According to statistics, in every second case of myelitis the cause is a viral infection .

But there are other reasons for the development of the pathological process:

• consequences of radiation therapy, which is often used in the treatment of cancer;
• allergic reaction to certain drugs;
• intoxication with lead, mercury or other chemicals, as well as certain medications, in particular psychotropic drugs;
• mechanical damage to the spine as a result of trauma.

On a note! Despite the high level of modern medicine, unfortunately, it is not always possible to determine the cause of the disease. It is assumed that the development of myelitis in such cases is associated with the functioning of the immune system. Therefore, severe hypothermia of the body can provoke the disease.

Classification of myelitis

The division of myelitis into different types, first of all, is required by the doctors themselves to correctly diagnose the inflammatory process and prescribe the appropriate course of therapy. Below are the main types of pathology.

Table. Main types of myelitis.

Causes of development, symptoms and treatment of viral myelitis

• Causes
• Symptoms
• Treatment
• Forecast

Viral myelitis is an inflammatory disease of the spinal cord, which is based on its damage by viral agents.

Most often it develops secondarily, against the background of an existing disease, for example, herpes. In rare cases, it can act as an independent disease.

The causative agent of the disease enters the nervous tissue through the blood or lymph.

It can develop at any age, regardless of gender. It is the most common disease on the planet, which most often results in disability. Recovery can take up to 3 months, and full recovery takes 3 years.

Causes

The main cause of viral myelitis is viruses that enter the spinal cord in different ways. These may be pathogens:

1. Flu.
2. Cytomegalovirus infection.
3. Rubella.
4. Herpes.
5. Coxsackie.
6. ECHO.
7. Enteroviruses.

This is not a complete list of viruses that can cause this type of myelitis. In most cases, a specific causative agent of inflammation in the spinal cord can be detected after a diagnostic examination of the cerebrospinal fluid.

The pathogenesis of the disease is quite simple. It all starts with the development of edema, which gradually compresses the nervous tissue and stops blood circulation in this area due to compression of the veins and arteries. This causes the development of tissue necrosis.

Blood clots gradually form in the vessels, which completely stop the supply of oxygen to the spinal cord. This gradually causes the irreversible death of nerve cells, and in their place connective tissue appears with the formation of a rough scar.

Since connective tissue is not able to perform the function of nerve cells, some part of the brain simply stops functioning.

Symptoms

Viral myelitis develops acutely and suddenly against the background of complete health. The temperature rises to 40 degrees, weakness and lethargy appear, nausea and vomiting, pain in muscles and joints may develop.

All these symptoms are typical for any viral infection. Therefore, myelitis in most cases is not diagnosed at the initial stage. Only after the appearance of back pain may the doctor suspect inflammation of the spinal cord.

The main symptoms will depend on which part of the brain is affected. It is most dangerous if the disease affects the cervical spine. In this case, spastic paresis of all limbs always develops, which can later turn into paralysis. Damage to the phrenic nerve is especially dangerous, since the patient stops breathing.

The thoracic spine is most often affected. This type of disease manifests itself as spastic paralysis of the legs with a predominance of high tone of the limbs.

The second most common lesions are the lower back and sacrum. Here, dysfunction of the pelvic organs, especially the bladder, predominates. Urinary retention occurs with the inability to empty the bladder independently.

At the same time, due to a violation of the innervation of the nerves, muscle atrophy occurs and after this it is sometimes impossible to restore muscle strength