Transverse Myelitis


Sx/Exam:

Diagnosis:

Treatment:

Acute:
acute neurological deficits
  • Corticosteroids:
    • methylprednisolone : 1000 mg IV qd for 3-5 days
  • supportive care + acute rehabilitation
  • plasmapheresis
  • supportive care + acute rehabilitation
Ongoing:
idiopathic TM
  • observation
at risk for multiple sclerosis (MS) (typical demyelinating lesions on MRI)
  • beta interferon or glatiramer
    • interferon beta 1a : 30 micrograms intramuscularly once weekly
      interferon beta 1b : 250 micrograms subcutaneously once daily on alternate days
      glatiramer : 20 mg subcutaneously once daily
aquaporin-4 autoantibody (neuromyelitis optica-IgG) seropositive
  • immunosuppressive treatment
    • azathioprine : see local specialist
      mycophenolate mofetil : see local specialist 
      rituximab : see local specialist