Acute transverse myelitis is acute inflammation of gray and white matter in one or more adjacent spinal cord segments, usually thoracic.
CAUSES : Multiple sclerosis, vasculitis, systemic lupus erythematosus (SLE), antiphospholipid syndrome, other autoimmune disorders, mycoplasmal infections, Lyme disease, syphilis, tuberculosis (TB), or viral meningoencephalitis myelitis neuromyelitis optica (Devic disease).
CLINICAL FEATURES : pain in the neck, back, or head, bandlike tightness around the chest or abdomen, weakness, tingling, numbness of the feet and legs, and difficulty voiding develop over hours to a few days.loss of sensation below the lesion, urinary retention, and fecal incontinence.
DIAGNOSIS : MRI of the spinal cord, CSF analysis, testing for neuromyelitis optica IgG, and other tests for treatable causes.
Differential diagnosis : Guillain-Barré syndrome, spinal cord compression, neuromyelitis optica from multiple sclerosis, deficiency of vitamin B12, folate, zinc, or copper), vascular insufficiency, and intraspinal tumors. deficiency of vitamin B12, folate, zinc, or copper), vascular insufficiency, and intraspinal tumors.
Rhus Tox – Pain in the neck or lower back lower back pain, worsening is there from sitting or rest. Motion, exercise and pressure tend to give relief. Sensation as if the back is broken from intense pain. Lower back is also sore shoulders. worse from motion and from cold air exposure. Warm application on the neck gives relief. Massages over the neck also offer relief.
Hypericum – indicated when there is violent sharp pain in the back. Walking and stooping are difficult from this,neck is very sensitive to touch where it is required. In cases needing it symptoms including numbness, tingling, burning in the limbs may be present.
Zincum met – It is a major medicine when there is numbness in limbs and back pain.
The pain is most felt when walking. There is also a burning sensation in the spine. This is worse when sitting. General weakness is felt with above symptoms.
Causticum – Muscle Weakness weakness of limbs and urinary bladder. Arms feel weak and lame to them. unsteadiness of forearm and hand muscles Electric shock like pain in legs may be present, loss of bladder control resulting in involuntary passage of urine.
Phosphorus –marked burning and sensitivity of the spine. back feels weak. Limbs weakness and numbness. Leg weakness is felt with trembling of legs when beginning to walk. stumbling while walking. Pain in the back is also there.
Kali Phos weakness in limbs. Pain in legs and back. General weakness may also attend it. well-indicated in cases of paralysis.
Colocynth – pain from the lower back radiates down the leg to feet. pain is shooting lightning like in nature. worse from slightest motion. Relief from heat application.
Picric Acid – numbness, prickling and muscle weakness in legs. Legs weakness is felt from even little walking where it is required. a crawling sensation in the legs is present. Burning along the spine may attend to the above symptoms. an aching and dragging sensation in the lower back. Worsen from motion.