Myelitis

Clinic

• Inflammation of the spinal cord which can disrupt normal responses from the brain to the rest of the body, and from the rest of the body to the brain.
• It is classified to several categories depending on the area or the cause of the lesion
• However, any inflammatory attack on the spinal cord is often referred to as transverse myelitis.

Types

• Acute flaccid myelitis: A polio-like syndrome that causes muscle weakness and paralysis.
• Poliomyelitis: disease caused by viral infection in the gray matter with symptoms of muscle paralysis or weakness
• Transverse myelitis: It is caused by axonal demyelination encompassing both sides of the spinal cord
• Leukomyelitis: Lesions in the white matter
• Meningococcal myelitis or Meningomyelitis: Lesions occurring in the region of meninges and the spinal cord

Sign / Symptoms

• Mostly fast progression in muscle weakness or paralysis starting with the legs and then arms with varying degrees of severity.
• Instability of posture and difficulty in walking or any movement.
• Pain in the back, extremities or abdomen
• Incomplete evacuation of bowel or constipation
• Respiratory problems
• Intractable vomiting
• Paresthesia / Hyperstasia / Radiculopathy
• Urinary urgency /Bladder incontinence / Difficulty or inability to void
• Constipation
• Radiculopathy
• Gait difficulty

Miasmatic analysis

• Myelitis + Incontinence: TBE, HTLV-1
• Myelitis + Urgency: HSV-1, HSV-2, HTLV-1
• Myelitis + Constipation: HSV-1, HSV-2, RBOL, EBV, LBB
• Myelitis + Paresthesia + Hyperestasia: HSV-1, HSV-2 , PLV, LBB
• Myelitis + Radiculopathy: HSV-1, HSV-2 ,LBB
• Myelitis, Flaccid: ADV, PLV, WNE
• In Poly-myelitis like syndrome, MMP is best
• In Ascending Myelitis, SHBV is suggested
• In Flaccid Myelitis, ADV, PLV and WNE are good
• In Hemorrhagic Myelitis, consider SHBV
• If there is LMN Sign / Symptoms, the miasm is PLV

Related diseases

• Acute disseminated encephalomyelitis: autoimmune demyelination of the brain causing severe neurological signs and symptoms
• Multiple sclerosis: demyelination of the brain and spinal cord
• Neuromyelitis optica or Devic's disease: immune attack on optic nerve and spinal cord
• Sjögren's syndrome: destruction of the exocrine system of the body
• Systemic lupus erythematosus: a systemic autoimmune disease featuring a wide variety of neurological signs and symptoms
• Sarcoidosis: chronic inflammatory cells form as nodules in multiple organs
• Atopy: an immune disorder of children manifesting as eczema or other allergic conditions. It can include atopic myelitis, which causes weakness.
• Immune-mediated myelopathies, heterogeneous group of inflammatory spinal cord disorders including autoimmune disorders with known antibodies

Cause

Viral myelitis	Bacterial myelitis:	Fungal myelitis	Autoimmune causes
HIV HTLV-1 HTLV-2 EV70 and EV71, CXA, CXB, ECHO, WNE JE TBE	Syphilis LBB MTB Mycoplasma pneumoniae	Cryptococcus neoformans Coccidioides immitis Blastomyces dermatitides Hystoplasma capsulatum. In immunocompromised hosts Candida species Aspergillus species zygomycetes.

Researches

• Transverse myelitis or leukomyelitis are often caused by the herpes viruses and influenza virus
• CMV