横向脊髓炎

定义

横向脊髓炎 is a condition caused by inflammation of the spinal cord. As a result, the covering (myelin sheath) around the nerve cells is damaged. This disturbs the signals between spinal nerves and rest of the body.

横向脊髓炎 can cause pain, muscle weakness, paralysis, bladder or bowel problems.

选择的名字

TM; Acute transverse myelitis; Secondary transverse myelitis; Idiopathic transverse myelitis

原因

横向脊髓炎 is a rare nervous system disorder. 在许多情况下，病因不明. However, certain conditions may lead to transverse myelitis:

• 细菌, 病毒, 寄生, 或者真菌感染, 比如艾滋病毒, 梅毒, 水痘带状疱疹(带状疱疹), 西尼罗病毒, Zika病毒, 肠道病毒, 和莱姆病
• 免疫系统紊乱，如 多发性硬化(MS), 干燥综合症, 红斑狼疮
• 其他炎症性疾病，如 结节病是一种结缔组织疾病 硬皮病
• 影响脊柱的血管紊乱

横向脊髓炎 affects men and women of all ages and races.

症状

症状 of transverse myelitis may develop within a few hours or days. 或者，它们可能在1到4周内发展. 症状会很快变得严重.

症状 tend to occur at or below the damaged area of the spinal cord. Both sides of the body are often affected, but sometimes only one side is affected.

症状包括:

感觉异常:

• 麻木
• 刺痛
• 刺痛
• 冷淡
• 燃烧
• 对触摸或温度敏感

肠道和膀胱症状:

• 便秘
• 无法排尿
• 尿频
• 憋尿困难
• 尿漏(尿失禁)

疼痛:

• 尖锐的或钝的
• 可以从你的下背部开始吗
• May shoot down your arms and legs or wrap around your trunk or chest

肌无力:

• 失去平衡
• Difficulty walking (stumbling or dragging your feet)
• Partial loss of function, which may develop into paralysis

性功能障碍:

• 难以达到性高潮(男性和女性)
• 男性勃起功能障碍

Other symptoms can include loss of appetite, fever, respiratory problems. Depression and anxiety can occur as a result of dealing with chronic pain and illness.

考试和测试

Your health care provider will take your medical history and ask about your symptoms. The provider will also do a nervous system examination to check for:

• 弱点 or loss of muscle function, such as muscle tone and reflexes
• 疼痛程度
• 不正常的感觉

Tests to diagnose transverse myelitis and to rule out other causes include:

• 核磁共振成像 of the spinal cord to check for inflammation or abnormalities
• 脊髓穿刺(腰椎穿刺)
• 血液测试

治疗

横脊髓炎的治疗有助于:

• 治疗引起这种情况的感染
• 减少脊髓炎症
• 缓解或减轻症状

你可能会得到:

• Steroid medicines given through a vein (IV) to decrease inflammation.
• 血浆交换疗法. This involves removing the liquid part of your blood (plasma) and replacing it with plasma from a healthy donor or with another fluid.
• 抑制免疫系统的药物.
• Medicines to control other symptoms such as pain, spasm, urinary problems, or depression.

您的提供者可能会建议:

• Physical therapy to help improve muscle strength and balance, the use of walking aids
• Occupational therapy to help you learn new ways to do daily activities
• Counseling to help you cope with the stress and emotional issues from having transverse myelitis

支持团体

You can ease the stress of illness by joining a support group. Sharing with others who have common experiences and problems can help you not feel alone.

前景(预测)

The outlook for people with transverse myelitis varies. Most recovery occurs within 3 months after the condition occurs. 对一些人来说，康复可能需要几个月到几年的时间. About a third of people with transverse myelitis recover completely. Some people recover with moderate disabilities, such as bowel problems and trouble walking. Others have permanent disability and need help with daily activities.

那些恢复机会可能不大的人是:

• 有快速发作症状的人
• People whose symptoms do not improve within the first 3 to 6 months

横向脊髓炎 usually only occurs once in most people. It may recur in some people with an underlying cause, such as MS. People who have involvement of only on one side of the spinal cord may be more likely to develop MS in the future.

可能出现的并发症

Ongoing health problems from transverse myelitis may include:

• 持续的疼痛
• 肌肉功能丧失部分或完全丧失肌肉功能
• 弱点
• 肌肉紧绷和痉挛
• 性问题

何时联系医疗专业人员

如果出现以下情况，请联系您的供应商:

• 你突然注意到, sharp pain in your back that shoots down your arms or legs or wraps around your trunk
• You develop sudden weakness or numbness of arm or leg
• 你失去了肌肉功能
• You have bladder problems (frequency or incontinence) or bowel problems (constipation)
• 即使治疗，你的症状也会恶化

参考文献

Fabian MT, Krieger SC, Lublin FD. Multiple sclerosis and other inflammatory demyelinating diseases of the central nervous system. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley and Daroff's Neurology in Clinical Practice. 8日艾德. Philadelphia, PA: Elsevier; 2022:chap 80.

海明威C. Demyelinating disorders of the central nervous system. 在:Kliegman RM, St. Geme JW, Blum NJ , Shah SS, Tasker RC and Wilson KM, eds. 纳尔逊儿科学教材. 21艾德. Philadelphia, PA: Elsevier; 2020:chap 618.

Lim PAC. 横向脊髓炎. 见:Frontera WR, Silver JK, Rizzo TD Jr .编. Essentials of Physical Medicine and Rehabilitation. 第四版. Philadelphia, PA: Elsevier; 2019:chap 162.

National Institute of Neurological Disorders and Stroke website. 横向脊髓炎. www.研究所.国家卫生研究院.gov/health-information/disorders/transverse-myelitis. 2023年1月20日更新. 2023年5月3日生效.