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