Myelitis: Difference between revisions

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(Created page with "=== Clinic === * '''Myelitis''' is inflammation of the spinal cord which can disrupt the normal responses from the brain to the rest of the body, and from the rest of the body to the brain. Inflammation in the spinal cord can cause the myelin and axon to be damaged resulting in symptoms such as paralysis and sensory loss. Myelitis is classified to several categories depending on the area or the cause of the lesion; however, any inflammatory attack on the spinal cord is...")
 
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=== Clinic ===
=== Clinic ===


* '''Myelitis''' is inflammation of the spinal cord which can disrupt the normal responses from the brain to the rest of the body, and from the rest of the body to the brain. Inflammation in the spinal cord can cause the myelin and axon to be damaged resulting in symptoms such as paralysis and sensory loss. Myelitis 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.
* 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 ===
=== Types ===


* Acute flaccid myelitis: a polio-like syndrome that causes muscle weakness and paralysis.
* [[Flaccid Paralysis miasms|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
* [[PLV, Polio Virus|Poliomyelitis]]: disease caused by viral infection in the gray matter with symptoms of muscle paralysis or weakness
* Transverse myelitis: caused by axonal demyelination encompassing both sides of the spinal cord
* [[Transverse myelitis]]: It is caused by axonal demyelination encompassing both sides of the spinal cord
* Leukomyelitis: lesions in the white matter
* Leukomyelitis: Lesions in the white matter
* Meningococcal myelitis (or meningomyelitis): lesions occurring in the region of meninges and the spinal cord
* Meningococcal myelitis or Meningomyelitis: Lesions occurring in the region of meninges and the spinal cord
 


=== Sign / Symptoms ===
=== Sign / Symptoms ===


* Most myelitis manifests fast progression in muscle weakness or paralysis starting with the legs and then arms with varying degrees of severity.  
* Mostly  fast progression in muscle weakness or paralysis starting with the legs and then arms with varying degrees of severity.
* Sometimes the dysfunction of arms or legs cause instability of posture and difficulty in walking or any movement.
* Instability of posture and difficulty in walking or any movement.
* Paresthesia which is a sensation of tickling, tingling, burning, pricking, or numbness of a person's skin with no apparent long-term physical effect.  
* Pain in the back, extremities or abdomen
* Pain in the back, extremities, or abdomen
* Urinary urgency
* Bladder incontinence
* Difficulty or inability to void
* Incomplete evacuation of bowel or constipation
* Incomplete evacuation of bowel or constipation
* Respiratory problems  
* Respiratory problems  
* Intractable vomiting
* Intractable vomiting
=== [[Entities list|Entities]] ===
* Paresthesia / Hyperstasia / Radiculopathy
* Paresthesia / Hyperstasia / Radiculopathy
* Urinary urgency /Bladder incontinence
* Urinary urgency /Bladder incontinence / Difficulty or inability to void
* Constipation
* Constipation
* Radiculopathy
* Radiculopathy
* Gait difficulty
* Gait difficulty
* Poly-myelitis like syndrome: MMP
* Myelitis, ascending: SHBV
* Myelitis, Flaccid: ADV, PLV, WNE
* Myelitis, Hemorrhagic: SHBV
* Myelitis, LMN: PLV




=== Miasmatic analysis ===


* Myelitis + Incontinence: TBE, HTLV-1
=== [[Miasmatic approach|Miasmatic analysis]] ===
* Myelitis + Urgency: HSV-1, HSV-2, HTLV-1
 
* Myelitis + Constipation: HSV-1, HSV-2, RBOL, EBV, LBB
* Myelitis + [[Urinary incontinence|Incontinence]]: [[TBE, Tick Borne Encephalitis|TBE]], [[HTLV-1, Human T lymphotropic virus type 1|HTLV-1]]
* Myelitis + Paresthesia + Hyperstasia: HSV-1, HSV-2 , PLV, LBB
* Myelitis + Urgency: [[HSV-1, Herpes Simplex Virus|HSV-1]], [[HSV-2, Herpes Simplex Virus|HSV-2]], [[HTLV-1, Human T lymphotropic virus type 1|HTLV-1]]
* Myelitis + Radiculopathy: HSV-1, HSV-2 ,LBB
* Myelitis + [[Constipation]]: [[HSV-1, Herpes Simplex Virus|HSV-1]], [[HSV-2, Herpes Simplex Virus|HSV-2]], [[RBOL, Measles, rubeola|RBOL]], [[EBV, Epstein Barr Virus|EBV]], [[LBB, Lyme Borreliosis Bacterium|LBB]]
* Myelitis, Flaccid: ADV, PLV, WNE
* Myelitis + [[Paresthesia]] + [[Hyperesthesia|Hyperestasia]]: [[HSV-1, Herpes Simplex Virus|HSV-1]], [[HSV-2, Herpes Simplex Virus|HSV-2]] , [[PLV, Polio Virus|PLV]], [[LBB, Lyme Borreliosis Bacterium|LBB]]
* Poly-myelitis like syndrome: MMP
* Myelitis + [[Radiculopathy]]: [[HSV-1, Herpes Simplex Virus|HSV-1]], [[HSV-2, Herpes Simplex Virus|HSV-2]] ,[[LBB, Lyme Borreliosis Bacterium|LBB]]
* Myelitis, ascending: SHBV
* Myelitis, [[Flaccid Paralysis miasms|Flaccid]]: [[ADV, Adenovirus|ADV]], [[PLV, Polio Virus|PLV]], [[WNE, West Nile Encephalitis|WNE]]
* Myelitis, Hemorrhagic: SHBV
* In Poly-myelitis like syndrome, [[MMP, Mumps|MMP]] is best
* Myelitis, LMN: PLV
* In Ascending Myelitis, [[SHBV, Herpes B Virus|SHBV]] is suggested
* In Flaccid Myelitis, [[ADV, Adenovirus|ADV]], [[PLV, Polio Virus|PLV]] and [[WNE, West Nile Encephalitis|WNE]] are good
* In Hemorrhagic Myelitis, consider [[SHBV, Herpes B Virus|SHBV]]
* If there is [[LMN, Lower Motor Neuron|LMN]] Sign / Symptoms, the miasm is [[PLV, Polio Virus|PLV]]




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* Immune-mediated myelopathies, heterogeneous group of inflammatory spinal cord disorders including autoimmune disorders with known antibodies
* Immune-mediated myelopathies, heterogeneous group of inflammatory spinal cord disorders including autoimmune disorders with known antibodies


=== Cause ===
* Direct infection by viruses, bacteria, mold, or parasites such as HIV, HTLV- I and II, EV70 and EV71, CXA, CXB, ECHO, WNE JE, TBE).
* Transverse myelitis or leukomyelitis, or white matter myelitis, are often caused by the herpesviruses and influenza virus
* Syphilis, LBB, and MTB
* Autoimmune causes 
=== Infectious myelitis [edit] ===
The location of motor neurons in the anterior horn cells of the spinal column will be affected by the polioviruses causing poliomyelitis.
* Viral myelitis
Most viral myelitis is acute, but the retroviruses (such as HIV and HTLV) can cause chronic myelitis. Poliomyelitis, or gray matter myelitis, is usually caused by infection of anterior horn of the spinal cord by the enteroviruses (
* Bacterial myelitis
Bacterial myelitis includes ''Mycoplasma pneumoniae'', which is a common agent for respiratory tract. Studies have shown respiratory tract infections within 4–39 days prior to the onset of transverse myelitis. Or, tuberculosis, syphilis, and brucellosis are also known to cause myelitis in immune-compromised individuals. Myelitis is a rare manifestation of bacterial infection.
* Fungal myelitis
Fungi have been reported to cause spinal cord disease either by forming abscesses inside the bone or by granuloma. In general, there are two groups of fungi that may infect the CNS and cause myelitis - primary and secondary pathogens. Primary pathogens include the following: ''Cryptococcus neoformans'', ''Coccidioides immitis'', ''Blastomyces dermatitides'', and ''Hystoplasma capsulatum''. Secondary pathogens are opportunistic agents that primarily infect immunocompromised hosts such as Candida species, Aspergillus species, and zygomycetes.
* Parasitic myelitis


Parasitic species infect human hosts through larvae that penetrate the skin. Then they enter the lymphatic and circulatory system, and migrate to liver and lung. Some reach the spinal cord. Parasitic infections have been reported with Schistosoma species, ''Toxocara canis'', Echinococcus species, ''Taenia solium'', ''Trichinella spiralis'', and Plasmodium species.
{| class="wikitable"
|+Cause
!Viral myelitis
!Bacterial myelitis:
!Fungal myelitis
!Autoimmune causes
|-
|
* [[HIV, Human immunodeficiency virus|HIV]]
* [[HTLV-1, Human T lymphotropic virus type 1|HTLV-1]]
* [[HTLV-2]]
* [[EV70]] and [[EV71]],  
* [[CXA, CXB, ECH, Coxsackie viruses & Echoviruses|CXA]], [[CXA, CXB, ECH, Coxsackie viruses & Echoviruses|CXB]], [[CXA, CXB, ECH, Coxsackie viruses & Echoviruses|ECHO]],
* [[WNE, West Nile Encephalitis|WNE]]
* [[JE, Japanese encephalitis|JE]]
* [[TBE, Tick Borne Encephalitis|TBE]]
|
* [[Syphilis]]
* LBB
* MTB
* ''Mycoplasma pneumoniae''
|
*''Cryptococcus neoformans''
*''Coccidioides immitis''  
*''Blastomyces dermatitides''  
*''Hystoplasma capsulatum''.
* In immunocompromised hosts
** Candida species
** Aspergillus species
** zygomycetes.
|
|}


=== Autoimmune myelitis[edit] ===
=== Researches ===
In 2016, it was identified in Mayo clinic an autoimmune form of myelitis due to the presence of anti-GFAP autoantibodies. Immunoglobulins directed against the α-isoform of glial fibrillary acidic protein (GFAP-IgG) predicted a special meningoencephalomyelitis termed autoimmune GFAP Astrocytopathy that later was found also to be able to appear as a myelitis.
* Transverse myelitis or leukomyelitis are often caused by the [[herpes viruses]] and influenza virus
* [[CMV, Cytomegalovirus|CMV]]

Latest revision as of 22:45, 1 September 2023

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


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
  • 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
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