Transverse myelitis
Definition
横贯脊髓炎是一种由脊髓炎症引起的疾病. 结果,神经细胞周围的覆盖层(髓鞘)受损. 这会干扰脊神经和身体其他部分之间的信号.
横贯脊髓炎可引起疼痛、肌肉无力、麻痹以及膀胱或肠道问题.
Alternative Names
TM; Acute transverse myelitis; Secondary transverse myelitis; Idiopathic transverse myelitis
Causes
横脊髓炎是一种罕见的神经系统疾病. In many cases, the cause is unknown. 然而,某些情况可能导致横贯脊髓炎:
- Bacterial, viral, parasitic, or fungal infection, such as HIV, syphilis, varicella zoster (shingles), West Nile virus, Zika virus, enteroviruses, and Lyme disease
- Immune system disorders, such as
multiple sclerosis (MS) ,Sjögren syndrome , andlupus - Other inflammatory disorders, such as
sarcoidosis , or a connective tissue disease calledscleroderma - Blood vessel disorders that affect the spine
横脊髓炎影响所有年龄和种族的男性和女性.
Symptoms
横脊髓炎的症状可在数小时或数天内出现. Or, they may develop over 1 to 4 weeks. Symptoms can quickly become severe.
症状往往发生在脊髓受损区域或以下. 身体的两侧经常受到影响,但有时只有一侧受到影响.
Symptoms include:
Abnormal sensations:
- Numbness
- Pricking
- Tingling
- Coldness
- Burning
- Sensitivity to touch or temperature
Bowel and bladder symptoms:
- Constipation
- Inability to urinate
- Frequent need to urinate
- Difficulty holding urine
- Urine leakage (incontinence)
Pain:
- Sharp or blunt
- May start in your lower back
- 可能会打断你的胳膊和腿,或者缠绕你的躯干或胸部
Muscle weakness:
- Loss of balance
- 行走困难(绊倒或拖脚)
- 部分功能丧失,可能发展为瘫痪
Sexual dysfunction:
- Difficulty having an orgasm (men and women)
- Erectile dysfunction in men
其他症状包括食欲不振、发烧和呼吸系统问题. 抑郁和焦虑可能是处理慢性疼痛和疾病的结果.
Exams and Tests
你的十大赌博平台排行榜会记录你的病史并询问你的症状. 提供者还将做神经系统检查,以检查:
- 肌肉无力肌肉功能的无力或丧失,如肌肉张力和反射
- Pain level
- Abnormal sensations
诊断横贯脊髓炎和排除其他原因的检查包括:
MRI 检查脊髓是否有炎症或异常Spinal tap (lumbar puncture) - Blood tests
Treatment
Treatment for transverse myelitis helps to:
- Treat an infection that caused the condition
- Reduce inflammation of the spinal cord
- Relieve or reduce symptoms
You may be given:
- 通过静脉(IV)给予类固醇药物以减少炎症.
- Plasma exchange therapy. 这包括去除你血液中的液体部分(血浆),用健康捐献者的血浆或其他液体代替.
- Medicines to suppress your immune system.
- 控制其他症状的药物,如疼痛、痉挛、泌尿系统问题或抑郁.
Your provider may recommend:
- 物理治疗,以帮助提高肌肉力量和平衡,并使用辅助行走
- 职业疗法帮助你学习日常活动的新方法
- 咨询,帮助你应付压力和情绪问题,从横脊髓炎
Support Groups
你可以通过参加互助小组来减轻疾病带来的压力. 与有共同经历和问题的人分享可以帮助你不感到孤独.
Outlook (Prognosis)
横脊髓炎患者的前景各不相同. 大多数在病情发生后3个月内恢复. For some, healing may take months to years. 大约三分之一的横断面脊髓炎患者能完全康复. 有些人康复后会出现中度残疾,比如肠道问题和行走困难. 其他人则有永久性残疾,日常活动需要帮助.
Those who may have poor chance of recovery are:
- People who have rapid onset of symptoms
- 在最初的3到6个月内症状没有改善的人
横型脊髓炎通常只发生一次. 它可能会在一些有潜在原因的人身上复发,比如多发性硬化症. 只有一侧脊髓受累的人将来更有可能患上多发性硬化症.
Possible Complications
横贯脊髓炎引起的健康问题包括:
- Constant pain
- Partial or complete loss of muscle function
- Weakness
- Muscle tightness and spasticity
- Sexual problems
When to Contact a Medical Professional
Contact your provider if:
- You notice a sudden, 背部的剧痛会刺痛你的手臂或腿,或者缠绕你的躯干
- 你突然感到四肢无力或麻木
- You have loss of muscle function
- 你有膀胱问题(尿频或尿失禁)或肠道问题(便秘)
- Your symptoms get worse, even with treatment
References
Fabian MT, Krieger SC, Lublin FD. 多发性硬化症和其他中枢神经系统的炎症性脱髓鞘疾病. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ,编辑. 布拉德利和达洛夫的《临床实践中的神经学. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 80.
Hemingway C. 中枢神经系统脱髓鞘紊乱. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC和Wilson KM编. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 618.
Lim PAC. Transverse myelitis. In: Frontera WR, Silver JK, Rizzo TD Jr, eds. 《物理医学与康复要领》. 4th ed. Philadelphia, PA: Elsevier; 2019:chap 162.
国家神经疾病和中风研究所网站. Transverse myelitis.
Review Date: 11/09/2021