As with many disorders of the spinal cord, no effective cure currently exists for people with transverse myelitis. Treatments are designed to manage and alleviate symptoms and largely depend upon the severity of neurological involvement. Therapy generally begins when the patient first experiences symptoms. Physicians often prescribe corticosteroid therapy during the first few weeks of illness to decrease inflammation. Although no clinical trials have investigated whether corticosteroids alter the course of transverse myelitis, these drugs often are prescribed to reduce immune system activity because of the suspected autoimmune mechanisms involved in the disorder. Corticosteroid medications that might be prescribed may include methylprednisone or dexamethasone. General analgesia will likely be prescribed for any pain the patient may have. And bedrest is often recommended during the initial days and weeks after onset of the disorder.
Following initial therapy, the most critical part of the treatment for this disorder consists of keeping the patient’s body functioning while hoping for either complete or partial spontaneous recovery of the nervous system. This may sometimes require placing the patient on a respirator. Patients with acute symptoms, such as paralysis, are most often treated in a hospital or in a rehabilitation facility where a specialized medical team can prevent or treat problems that afflict paralyzed patients. Often, even before recovery begins, caregivers may be instructed to move patients’ limbs manually to help keep the muscles flexible and strong, and to reduce the likelihood of pressure sores developing in immobilized areas. Later, if patients begin to recover limb control, physical therapy begins to help improve muscle strength, coordination, and range of motion.
What therapies are available to help patients left with permanent physical disabilities?
Many forms of long-term rehabilitative therapy are available for people who have permanent disabilities resulting from transverse myelitis. Medical social workers, often affiliated with local hospitals or outpatient clinics, are the best sources for information about treatment programs and other resources that exist in a community. Rehabilitative therapy teaches people strategies for carrying out activities in new ways in order to overcome, circumvent, or compensate for permanent disabilities. Rehabilitation as yet cannot reverse the physical damage resulting from transverse myelitis or other forms of spinal cord injury. But it can help people, even those with severe paralysis, become as functionally independent as possible and thereby attain the best possible quality of life.
Commonly experienced permanent neurological deficits resulting from transverse myelitis include severe weakness, spasticity (painful muscle stiffness or contractions), or paralysis; incontinence; and chronic pain. Such deficits can substantially interfere with a person’s ability to carry out everyday activities such as bathing, dressing, and performing household tasks.
People living with permanent disability may feel a range of emotions, from fear and sadness to frustration and anger. Such feelings are natural responses, but they can sometimes jeopardize health and potential for functional recovery. Those with permanent disabilities frequently experience clinical depression. Fortunately, depression is treatable, due to the development of a wide range of medications that can be used with psychotherapeutic treatment.
Today, most rehabilitation programs attempt to address the emotional dimensions along with the physical problems resulting from permanent disability. Patients typically consult with a range of rehabilitation specialists, who may include physiatrists (physicians specializing in physical medicine and rehabilitation), physical therapists, occupational therapists, vocati...