In this article, we will discuss the Clinical Features of Acute Transverse Myelitis. So, let’s get started.
Patient may be of any age, presents with acute onset of neck or back pain followed by paraplegia or quadriplegia with a variable combinations of paresthesias, sensory loss, motor weakness and sphincter disturbances, evolving within hours to several days. The sensory symptoms precede the motor symptoms. Sensory symptoms may be mild only or there may be a devastating functional transection of the cord. Paresthesias may begin in one lower limb (starting from the foot) followed by other limb and ascend symmetrically or asymmetrically to the trunk where transverse involvement of the cord produces a sharp girdle like pain (a band of construction around the abdomen or trunk) with the sharply defined spinal cord level indicating the myelopathic nature of the process- this feature differentiates it from acute Guillain-Barré syndrome.
Sensory symptoms are followed by motor system involvement with upper motor neuron signs (exaggerated deep reflexes). In severe cases, the deep tendon jerks or reflexes may be absent due to spinal neuronal shock, but persistence of areflexia over few segments of spinal cord indicates acute necrotic myelitis.