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Causes
By Mayo Clinic staffInflammation is a normal response of the immune system to disease or injury. But sometimes the immune system attacks the body's own tissues — an event known as an autoimmune phenomenon. The exact reason for this immune system dysfunction in transverse myelitis is not known. However, there are a number of conditions that appear to trigger or contribute to the disorder. These conditions include:
- Viral infections of the respiratory tract or the gastrointestinal tract have been implicated in transverse myelitis. In most cases, the inflammatory disorder appears after a person has recovered from the viral infection.
- Mycoplasma pneumonia, a relatively mild form of pneumonia caused by a bacterium, may act as a trigger for the immune system mechanisms causing transverse myelitis.
- Multiple sclerosis is an autoimmune disorder in which the immune system destroys myelin surrounding nerves in your spinal cord and brain. Transverse myelitis may be the first sign of multiple sclerosis or represent a relapse of symptoms. Transverse myelitis occurring as a sign of multiple sclerosis usually manifests on one side of your body only.
- Neuromyelitis optica (Devic's disease) is a condition that causes inflammation and loss of myelin around the spinal cord and the optic nerve, the nerve in your eye that transmits information to your brain. Signs and symptoms of transverse myelitis associated with neuromyelitis optica usually affect both sides of your body. Damage to myelin of the optic nerve and subsequent symptoms, including pain in the eye with movement and temporary vision loss, may occur at the same or other times as transverse myelitis symptoms. However, some people with neuromyelitis optica may not experience eye-related problems and may only have recurrent episodes of transverse myelitis.
- Autoimmune disorders affecting other body systems are likely contributing factors in some people with transverse myelitis. These disorders include lupus, which can affect multiple body systems, and Sjogren's syndrome, which causes severe dryness of the mouth and eyes, as well as other symptoms. Transverse myelitis associated with an autoimmune disorder may indicate coexisting neuromyelitis optica, which occurs more frequently in people with other autoimmune diseases than it does in other people who don't have autoimmune disease.
- Vaccinations for infectious diseases — including hepatitis B, measles-mumps-rubella, and diphtheria-tetanus vaccines — have rarely been identified as a likely trigger.
References
- Transverse myelitis fact sheet. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/transversemyelitis/detail_transversemyelitis.htm. Accessed Oct. 24, 2010.
- Frohman EM, et al. Clinical practice: Transverse myelitis. New England Journal of Medicine 2010;363:564.
- Bhat A, et al. The epidemiology of transverse myelitis. Autoimmunity Reviews 2010;9:A395.
- Jacob A, et al. An approach to the diagnosis of acute transverse myelitis. Seminars in Neurology 2008;28:105.
- Weinshenker BG (expert opinion). Mayo Clinic, Rochester, Minn. Nov. 3, 2010.
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