Myelitis: Treatment, Cost and Side Effects

Myelitis is inflammation of the spinal cord which causes disruption of responses from the brain to the spinal cord and from the spinal cord to the brain. The myelitis is the fatty tissue protecting the nerve fibers from shocks and external damages. So when the myelin is damaged, the nerves underneath are exposed and can easily be bruised. This damage to the myelin results in paralysis and sensory loss. However, myelitis can be classified into four categories depending on the area of the nerve damaged.

Poliomyelitis often referred to as polio or infinite paralysis, is an infection caused by the poliovirus. The infection generally occurs in the brain leading to muscle paralysis. However, in most case of polio, there are no symptoms as such. The infection is usually spread from person to person. It is usually spread via fecal-oral route by ingesting contaminated food and water and via oral-oral routes. Another type of myelitis is leukomyelitis where damage is made in the white matter. The third type is transverse myelitis where inflammation occurs on both sides of one section of the spinal cord that leads to muscle weakness, paralysis or sensory problems and bowel dysfunction. The fourth type is meningococcal myelitis or meningomyelitis where injury is made in the region of the meninges and the spinal cord.

The exact cause of myelitis is not known and research is ongoing to find out more this. However, myelitis can occur due to infections caused by bacteria, fungi, parasites and virus. Diseases like human immunodeficiency (HIV), human T-lymphotropic, syphilis, lyme disease and tuberculosis causes the inflammation of the spinal cord. As a result of contracting these diseases, the immune system of the body attacks the spinal cord.

For proper treatment of myelitis, you will be asked to go for the following tests like MRI scans which provides images of the spinal cord, lumbar puncture (spinal tap) which tests the cerebrospinal fluid (CSF) to see numbers of white blood cells in the immune system. Other generic tests may include blood test and a clinical assessment of the nerve functions. Therefore, a treatment will be based on tests that will indicate what type of myelitis you have. Treatment for poliomyelitis involves getting polio vaccinations. Multiple doses of vaccination are required for it to be effective. Other than this there is no other cure for poliomyelitis. Treatment is generally done to provide relief of symptoms and help the person live a better life without complications. Some of the medications like antiviral drugs and medicines to treat chronic pain and other symptoms like bowel dysfunction, depression and others are also used to treat other types of myelitis.

Treatment for Transverse myelitis involves giving antiviral drugs and medications to treat various symptoms. The most important treatments for transverse myelitis include intravenous steroids and plasma exchange therapy. In intravenous method, steroids are injected into your body to reduce inflammation of the spinal column. In plasma exchange therapy, your blood plasma is removed and is replaced with a fluid. Another treatment known as intravenous immunoglobulin is a process by which antibodies are injected into the body.

People having any one type of myelitis can undergo the treatments mentioned for myelitis. General symptoms include muscle weakness or paralysis which can occur within hours to days. Muscle weakness is often associated with lower back pain and also pain in other areas like legs and abdomen. Other symptoms of myelitis are tingling, coldness, numbness or burning, bowel dysfunction, respiratory problems and also constipation. However, poliomyelitis does not show any symptoms and is difficult to diagnose the disease. It’s important to go to a doctor immediately after the appearance of any of the above mentioned symptoms.

People having compression of the spinal cord or stroke of the spinal cord display similar symptoms to myelitis but is not eligible for the treatment of the disease.

Some of the treatments mentioned for myelitis like intravenous steroids and immunoglobulin can have possible side effects like stomach irritations (indigestion and heartburn), increased energy, rapid heartbeat, flushing of the face, neck or chest, feeling warm or cool and retaining fluid, headache, fever, fatigue, chills, chest tightness, vomiting, nausea and flushing. However, there are certain complications of myelitis which a person suffers from after the treatment is over like pain, muscle spasticity (stiffness or tightness in legs or buttocks), partial or total paralysis, sexual dysfunction and depression or anxiety. These complications results from transverse myelitis. Poliomyelitis leads to complications like muscle paralysis, unable to walk properly, scoliosis (curving of the spinal cord or backbone), osteoporosis and bone fractures.

There is no definitive post-treatment guidelines for myelitis. However, doctors always advise to follow a healthy lifestyle and take rest as much as possible to recover faster. You can start by making certain dietary changes like including more fruits, vegetables and lean meats like fish and chicken in your diet. As your immune system is low, try have foods which are rich in iron and calcium. Calcium rich foods include yoghurt, cheese, banana and milk.

Physical activities also help in reducing muscle spasticity, walking difficulties and muscle weakness. You can do freehand exercises on your own or go for physical therapists. Exercising will not only improve your posture but also increase your stamina and energy level. However, before starting any sort of exercising you should consult a doctor .

Most people suffering from myelitis have partial recovery which can take months to a year. In most cases, improvements can be seen within first three months. Recovery can be categorized into three stages. Stage one means full recovery with few symptoms still existing. In stage two, the patient makes partial recovery with temporary paralysis such as difficulty walking, muscle weakness and numbess. The last stage is characterized by minimal recovery where paralysis is permanent and requires life long assistance.

The cost of treating myelitis in India is high as there is no definite cure and includes injecting medications and therapies to help a patient recover faster. The price usually starts at Rs.1,000 and can go up to Rs.1,00,000

There is no definite cure for myelitis and treatment are only given to provide relief from symptoms. Therefore, the results are also not permanent as patients making full recovery still can have lingering symptoms or partial paralysis.

Alternative treatments greatly help in dealing and coping with myelitis. Some of these alternative methods include physical therapy that helps in muscle stiffness and weakness, occupational therapy that helps in performing day-to-day activities and psychotherapy that helps with depression, anxiety and stress.