Transverse Myelitis Vaccine Injury Cases

What is Transverse Myelitis (TM)?

Transverse myelitis is an inflammation of the spinal cord, a major part of the central nervous system.  The spinal cord carries nerve signals to and from the brain through nerves that extend from each side of the spinal cord and connect to nerves elsewhere in the body.  The term myelitis refers to inflammation of the spinal cord; transverse refers to the pattern of changes in sensation—there is often a band-like sensation across the trunk of the body, with sensory changes below.  Inflammation within the spinal cord interrupts communications between nerve fibers in the spinal cord and the rest of the body, affecting sensation and nerve signaling below the injury.  Symptoms include pain, sensory problems, weakness in the legs and possibly the arms, and bladder and bowel problems.  The symptoms may develop suddenly (over a period of hours) or over days or weeks.

What is the prognosis?

Most people with transverse myelitis have at least partial recovery, with most recovery taking place within the first 3 months after the attack.  For some people, recovery may continue for up to 2 years (and in some cases, longer).  However, if there is no improvement within the first 3 to 6 months, complete recovery is unlikely (although partial recovery can still occur and still requires rehabilitation).  Aggressive acute treatment and physical therapy have been shown to improve outcomes.  Some individuals are left with moderate disability (such as trouble walking, nerve sensitivity, and bladder and bowel problems) while others may have permanent weakness, spasticity, and other complications.  Myelitis attacks with neuromyelitis optica spectrum disorder (NMOSD) tend to be more severe and are associated with less recovery than attacks with multiple sclerosis.  Research has shown that a rapid onset of symptoms generally results in poorer recovery.

What treatment is available?

Treatments are designed to address infections that may cause the disorder, reduce spinal cord inflammation, and manage and alleviate symptoms.   Intravenous corticosteroid drugs, plasma exchange therapy (plasmapheresis), intravenous immunoglobulin (IVIg), pain medicines, and antiviral medications have all been used to treat individuals with transverse myelitis.  Usually, physicians will utilize one of these treatment regimens and determine its success before moving to another treatment.

Can TM be caused by vaccines?

Transverse myelitis can be caused by other immune system disorders, viral infections, bacterial infections and fungal infections.  Vaccinations for infectious diseases — including influenza, hepatitis B, measles-mumps-rubella and diphtheria-tetanus vaccines — have occasionally been associated as a possible trigger for transverse myelitis.

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