Transverse Myelitis

UT Southwestern Medical Center has established an international reputation for providing care for transverse myelitis (TM), which is an inflammatory condition of the spinal cord that causes varying degrees of weakness, sensory alterations, and autonomic dysfunction.

The Transverse Myelitis Program at UT Southwestern, only the second dedicated program for TM in the world, is recognized as a leader in the research and treatment of TM. Our team has been focused on this condition since 2009, and we work in conjunction with the Siegel Rare Neuroimmune Association to provide comprehensive care to patients with TM, serving patients from around the world.

Individualized Strategies for Improved Function and Control

TM is a central nervous system disorder that affects adults and children. The true incidence is unknown, with one study estimating 1,400 cases per year. A variant of TM, acute flaccid myelitis (AFM), has been increasing in prevalence but primarily affects children.TM can be caused by autoimmune conditions such as multiple sclerosis or neuromyelitis optica spectrum disorder (NMOSD), or it can occur after an infection, in which case it’s referred to as idiopathic transverse myelitis.

UT Southwestern’s Transverse Myelitis Program addresses the wide range of symptoms that can make TM difficult to treat. Patients have access to experts in virtually every discipline related to the diagnosis and treatment of the disease; these specialists craft individualized strategies to give patients improved function and greater control.

We also treat other autoimmune diseases, such as NMOSD, multiple sclerosis (MS), and autoimmune encephalitis.

Symptoms of Transverse Myelitis

Symptoms of TM can vary widely from patient to patient, and they often fluctuate over time.

The spinal cord contains two sections of cells:

The gray matter includes neurons that project out to muscles.
The white matter projects to and from the brain. These white matter tracts also carry sensory information from the body to the brain, and from the brain to the gray matter neurons.

Patients with damage to white matter might have different symptoms than patients with damage restricted to gray matter.

Symptoms can include:

Balance disorders
Bladder or bowel problems
Changes in gait
Depression or other emotional changes
Difficulties with muscle coordination and walking
Fatigue
Numbness or tingling
Pain
Sexual dysfunction
Spasticity
Tremors
Weakness

Diagnosing Transverse Myelitis

Accurate diagnosis and timely treatment of TM is critical. UT Southwestern specialists are experts at differentiating potential mimics of TM, including spinal cord compression, arterial events of the spinal cord, and venous infarction of the spinal cord potentially caused by dural arteriovenous fistulas.

To diagnose TM, we collect information from a variety of tests and imaging studies to find evidence of damage to the spinal cord that is consistent with inflammation and not consistent with other causes.

We conduct a careful medical history, a neurologic exam, and a variety of tests that can include:

Blood tests
Evoked potentials (EP)
Optical coherence tomography (OCT)
Magnetic resonance imaging (MRI)
Spinal fluid analysis

Treatment for Transverse Myelitis

UT Southwestern specialists provide individualized, multidisciplinary treatment plans to maximize each person’s abilities and minimize disabilities. A patient’s care team might include:

Clinical nurses
Neurologists
Advanced practice providers (physician assistants and nurse practitioners)
Neuro-ophthalmologists
Neuropsychologists and psychiatrists
Neuroradiologists
Occupational therapists
Physical therapists
Rehabilitation specialists
Social workers
Registered dietitians
Urologists

Acute therapy for TM includes high doses of corticosteroids and, in some patients, plasma exchange therapy. Other interventions are considered on an individual basis. Beyond the anti-inflammatory therapies for TM, rehabilitation is essential to recovery.

The goal of treatment is to ensure that all active inflammation is extinguished and then focus on recovery and symptom management. The UT Southwestern team also works to ensure that a complete workup for potential causes of TM has been completed. In addition to finding the best medicine for each individual, we also empower patients by treating symptoms of TM with medications, nutrition, exercises, and assistive devices.

Personalized treatment plans help patients sustain and improve functionality over the course of their illness, enable them to participate in more activities, and provide hope for their futures.

Support Services

The UT Southwestern Transverse Myelitis Program works closely with the Siegel Rare Neuroimmune Association (SRNA) to help people with TM and their families stay educated about new treatments and new research.

Siegel Rare Neuroimmune Association Support Group

SRNA sponsors a network of support groups around the nation and several in Texas. Visit the SRNA website for a listing of support groups and contact information.

Clinical Trials

We are leaders in research for transverse myelitis, helping to improve understanding and treatments for patients through clinical trials. Current clinical trials include: