Covid-19 and Transverse Myelitis

Rare Spinal Cord Disorder Post COVID-19: Transverse Myelitis

COVID-19 pandemic has directly impacted the lives of millions of people in many ways over the past year. The researchers and scientists continue to study the coronavirus and its after-effects each day.

The researchers continue to focus on the effects after recovery from COVID-19 is known as long haulers. These are people dealing with the lingering effects of COVID such as chronic lung disease, cognitive decline, and psychological effects.

Researchers have come across a possible connection between COVID-19 and a rare spinal cord disorder known as transverse myelitis (TM). To date, three known cases of acute transverse myelitis due to COVID-19 have been reported.

What is Transverse Myelitis?

Transverse myelitis is a rare spinal cord disorder leading to inflammation of both sides of one section of the spinal cord. This rare neurological disorder damages the myelin, which is the insulating material covering nerve cell fibers.

Transverse myelitis interferes with the messages sent by the spinal cord nerves throughout the body. This may result in pain, muscle weakness, sensory problems, or bladder, bowel dysfunction, and even paralysis.

Myelin plays an important role in insulation that is essential for normal motor function, sensory function, and cognition. If the myelin is affected, the electrical impulses sent and received by the spinal cord can bleed off and nerves don’t get the messages. This can result in muscle spasms, twitching, numbness, and more.

Transverse Myelitis can develop for various reasons, including infections and immune system disorders that attack your body's tissues. It can also be caused by myelin disorders, such as multiple sclerosis. Sometimes, other medical conditions such as stroke or spinal cord can also be confused with transverse myelitis. But, these conditions require different treatment approaches.

People of any race, gender, or age can be affected by Transverse myelitis. There are treatments available to control the symptoms but there is no cure. The treatments such as corticosteroids and other therapies are only aimed at preventing or minimizing permanent neurological damage.

COVID-19 can also lead to the development of transverse myelitis due to prolonged neurological consequences. COVID-19 can lead to acute transverse myelitis because of a possible inflammatory complication affecting the myelin of the spinal cord.

How to Identify Transverse Myelitis?

Transverse myelitis symptoms can usually develop over a few hours to a few days and may sometimes progress gradually over several weeks. This neurological disorder generally impacts both sides of the body below the affected area of the spinal cord.

The most common signs and symptoms include:

• Pain: The pain is experienced as a sharp pain that may begin suddenly in your lower back and shoot down your legs or arms or around your chest or abdomen. The pain symptoms depend on the part of your spinal cord that's affected.
• Abnormal sensations: If affected with transverse myelitis, you may experience numbness, tingling, coldness, or burning. Some people are sensitive to the light touch of clothing or extreme heat or cold. You may also feel like something is tightly wrapping the skin of your chest, abdomen, or legs.
• Weakness in your arms or legs: Heaviness in the legs is also a common symptom and you may be stumbling or dragging one foot. In severe cases, you may develop extreme weakness or even total paralysis.
• Bladder and bowel problems: You may be needing the urge to urinate more frequently, urinary incontinence, difficulty urinating, and constipation..

The less common symptoms of transverse myelitis may include muscle spasms, feeling of discomfort, headache, fever, and loss of appetite.

The healthcare provider will diagnose transverse myelitis through various methods. Most physicians will perform a neurological exam, attempting to first rule out any issues that would require emergency intervention.

The doctor would order several diagnostic tests when they suspect transverse myelitis, such as:

• Magnetic resonance imaging (MRI)
• Blood tests
• Lumbar puncture

How to Treat Transverse Myelitis?

Currently, doctors treat the symptoms as well as manage complications associated with transverse myelitis as there is no cure. The researchers are working on developing a cure.

Several therapies help in controlling the acute signs and symptoms of transverse myelitis:

• Intravenous steroids: Steroids are injected through a vein in your arm over several days. This would help reduce the inflammation in your spinal column.
• Plasma exchange therapy: This therapy involves removing the straw-colored fluid that contains suspended blood cells or plasma, and replacing the plasma with special fluids. This therapy helps in removing the inflammatory antibodies.
• Antiviral medication: These medications help treat people with viral infections such as coronavirus.
• Pain medication: Pain is the main symptom of transverse myelitis. Medications are prescribed to reduce muscle pain such as common pain relievers - acetaminophen (Tylenol, others), ibuprofen (Advil, Motrin IB, others), and naproxen sodium (Aleve). If the patient has nerve pain doctor may also prescribe antidepressant drugs, such as sertraline (Zoloft), and anticonvulsant drugs, such as gabapentin (Neurontin, Gralise) or pregabalin (Lyrica).
  Medications are also helpful in treating other complications such as muscle spasticity, urinary or bowel dysfunction, depression, or other complications associated with transverse myelitis. To prevent the recurrence of transverse myelitis medicines are very effective. If you have antibodies associated with neuromyelitis optica needs ongoing medications, like corticosteroids and immunosuppressants, to reduce their chances of more transverse myelitis attacks or developing optic neuritis.

Some of the other therapies focus on long-term recovery and care:

• Physical therapy: This helps improve strength and coordination with the help of assistive devices, such as a wheelchair, canes, or braces.
• Occupational therapy: This involves learning new ways of performing day-to-day activities, such as bathing, preparing a meal, and house cleaning.
• Psychotherapy: A psychotherapist helps to treat anxiety, depression, sexual dysfunction, and other emotional or behavioral issues from coping with transverse myelitis.

Outlook

COVID-19 has impacted millions of people around the world. Although with very few cases but there’s a possible connection between COVID-19 and a rare spinal cord disorder transverse myelitis (TM).

People Also Read:

• How to Deal with Post-Covid Syndrome?
• Are People Pausing Healthcare Services Due to the Pandemic?

If you or anyone you know is suffering from the effects of Covid-19, our expert providers at Post Covid Centers will take care of your health and help you recover.

Call 469-545-9983 to book a telehealth appointment for a home check-up.