Transverse myelitis

Transverse myelitis

Pathology

Central nervous system disorders

Brain herniation
Broca aphasia
Kluver-Bucy syndrome
Wernicke aphasia
Adult brain tumors
Adult brain tumors: Pathology review
Acoustic neuroma (schwannoma)
Pituitary adenoma
Pediatric brain tumors
Pediatric brain tumors: Pathology review
Ischemic stroke
Transient ischemic attack
Cerebral vascular disease: Pathology review
Meningitis
Neonatal meningitis
Encephalitis
Brain abscess
Epidural abscess
Cavernous sinus thrombosis
Creutzfeldt-Jakob disease
Central nervous system infections: Pathology review
Aqueductal stenosis
Cerebral palsy
Chiari malformation
Dandy-Walker malformation
Septo-optic dysplasia
Spina bifida
Spinocerebellar ataxia (NORD)
Syringomyelia
Tethered spinal cord syndrome
Congenital neurological disorders: Pathology review
Alzheimer disease
Creutzfeldt-Jakob disease
Dementia with Lewy bodies
Frontotemporal dementia
Normal pressure hydrocephalus
Vascular dementia
Dementia: Pathology review
Acute disseminated encephalomyelitis
Central pontine myelinolysis
JC virus (Progressive multifocal leukoencephalopathy)
Multiple sclerosis
Transverse myelitis
Demyelinating disorders: Pathology review
Cavernous sinus thrombosis
Cluster headache
Idiopathic intracranial hypertension
Migraine
Tension headache
Trigeminal neuralgia
Headaches: Pathology review
Arteriovenous malformation
Epidural hematoma
Intracerebral hemorrhage
Saccular aneurysm
Subarachnoid hemorrhage
Subdural hematoma
Traumatic brain injury: Pathology review
Essential tremor
Huntington disease
Opsoclonus myoclonus syndrome (NORD)
Parkinson disease
Restless legs syndrome
Torticollis
Movement disorders: Pathology review
Wernicke-Korsakoff syndrome
Early infantile epileptic encephalopathy (NORD)
Febrile seizure
Seizures and epilepsy
Seizures: Pathology review
Brown-Sequard Syndrome
Cauda equina syndrome
Friedreich ataxia
Neurogenic bladder
Syringomyelia
Treponema pallidum (Syphilis)
Vitamin B12 deficiency
Spinal cord disorders: Pathology review
Concussion and traumatic brain injury
Shaken baby syndrome
Traumatic brain injury: Pathology review

Autonomic nervous system disorders

Flashcards

Transverse myelitis

0 of 6 complete

Transcript

Watch video only

The name of the disorder transverse myelitis can be broken down. Transverse means extending completely across something - in this case, it refers to going across the spinal cord, and myelitis means inflammation of myelin which is the fatty substance surrounding nerves.

So, in transverse myelitis there’s inflammation that damages the myelin as well as the rest of the neuron across a section of the spinal cord.

Now, neurons are the main cells of the nervous system. They’re composed of a cell body, which contains all the cell’s organelles, and nerve fibers, which are projections that extend out from the neuron cell body.

Nerve fibers are either dendrites that receive signals from other neurons, or axons that send signals along to other neurons.

Where two neurons come together is called a synapse, and that’s where one end of an axon sends neurotransmitters to the dendrites or directly to the cell body of the next neuron in the series.

The axons are intermittently wrapped in a fatty substance called myelin.

Myelin is extremely important to neurons, because it helps to allow an action potential to propagate much faster.

An action potential is an electrical signal that races down the axon, triggering the release of neurotransmitters or a chemical signal, on the other end.

Without myelin this signal propagation is very slow and inefficient.

Since some of these neurons can be very long, especially ones that go from the spinal cord to the toes, the fact that myelin helps speed up action potentials is super important!

Now, the spinal cord is composed of both grey and white matter.

Grey matter consists of cell bodies. It’s in the middle of the spinal cord and is shaped like a butterfly.

Surrounding the grey matter is white matter, which consists of the myelinated axons of various neurons.

The neurons in the spinal cord form different neural tracts that carry information to and from the brain.

There are three main tracts to remember. The corticospinal tract is a descending pathway that carries motor information from the brain to different muscles in the body and it controls voluntary muscle movement.

The dorsal column is an ascending pathway that carries sensory information about pressure, vibration, fine touch, and proprioception--or the awareness of one’s bodily position in space.

Finally, the spinothalamic tract is another ascending pathway and it’s divided into two parts.

The lateral tract carries sensory information for pain, pressure, and temperature, while the anterior tract carries information for crude touch--or the sense one has been touched, but without being able to localize where they were touched.

Autonomic neurons are also located in the spinal cord--these help regulate processes like urination, digestion, and heart rate.

These neurons hitch a ride with the various tracts, but their cell bodies are found in the spinal cord.

For example, the sympathetic division, or the fight response, has its cell bodies in the thoracic and lumbar regions and make up the lateral horns of the grey matter.

Key Takeaways

Transverse myelitis is a neurological disorder characterized by an inflammation that damages the myelin as well as the rest of the neurons across a section of the spinal cord. It's a rare disease that can be triggered by an infectious or autoimmune process.

The symptoms are related to the affected part of the spinal cord. When the corticospinal tract is affected a person will have problems with voluntary movement, and when the spinothalamic tract is damaged a person will have problems sensing pain. If it is the dorsal column pathway that is damaged, a person will have problems with balance and spatial orientation.

Diagnosis can be done with a lumbar puncture which is when a needle is used to collect and analyze cerebrospinal fluid from around the spinal cord. In addition, an MRI, or magnetic resonance imaging, can be used to spot areas of inflammation in the spinal cord. Treatment of transverse myelitis depends on the underlying cause. If there's an autoimmune process, it may be helpful to use steroids or plasmapheresis, which is where antibodies are filtered out of the blood.

Sources

  1. "Robbins Basic Pathology" Elsevier (2017)
  2. "Harrison's Principles of Internal Medicine, Twentieth Edition (Vol.1 & Vol.2)" McGraw-Hill Education / Medical (2018)
  3. "Pathophysiology of Disease: An Introduction to Clinical Medicine 8E" McGraw-Hill Education / Medical (2018)
  4. "CURRENT Medical Diagnosis and Treatment 2020" McGraw-Hill Education / Medical (2019)
  5. "Transverse myelitis" Autoimmunity Reviews (2012)
  6. "Immunopathogenesis of acute transverse myelitis" Current Opinion in Neurology (2002)
  7. "Central Pattern Generator for Locomotion: Anatomical, Physiological, and Pathophysiological Considerations" Frontiers in Neurology (2013)