Transverse Myelitis

Official Ninja Nerd Website: ninjanerd.org
You can find the NOTES and ILLUSTRATIONS for this lecture on our website at:
www.ninjanerd.org/lecture/tra...
In this lecture Professor Zach Murphy will be presenting on Transverse Myelitis. During this lecture we will be discussing the etiology and pathophysiology, clinical features, diagnosis, and treatment of Transverse Myelitis. We hope you enjoy this lecture and be sure to support us below!
Table of Contents:
0:00 Lab
0:08 Transverse Myelitis Introduction
0:24 Etiology and Pathophysiology
9:36 Clinical Features
15:24 Diagnosis
18:46 Treatment
21:38 Prevention
23:43 Outro: As Always, Until Next Time
23:50 Comment, Like, SUBSCRIBE!
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#ninjanerd #transversemyelitis

[@pklmempk]

I was diagnosed last yr with idiopathic transverse myelitis of the cervical spine and have a permanent lesion the full length of my spine. My upper limbs were paralyzed and lower limbs were weak. After having high dose IV and oral steroids, spinal tap, and 5 treatments of plasmapharesis, and months of physical and occupational therapy I have recovered about 75% of my strength but still have difficulty with fine motor skills and use of the deltoids in my arms. TM is very rare, esp. if you are 71 yrs old. I understood the overall aspects presented in this video since I have personal experience with TM and continue to research the underlying causes, treatments, and prognosis since there is no cure but you either get stronger or you don’t…and I did, thankfully.

[@christinablizzard1064]

Hi there. Have you tried PRP injections? (Plasma Rich Platelets) I had that done during the summer and it was helping tremendously! BUT….. then I got the covid vaccine…. & all of my pain came back 🙁. Doctors refuse to admit I have TM I think because of its close association with vaccines. I wish you luck & good health & healing!

[@pklmempk]

@@christinablizzard1064 I have rec’d all 3 Moderna vaccinations and have not seen any negative responses that have affected my TM. However, that was the first question the drs. asked when they were trying to diagnose me last year but vaccinations did not play a part in my TM onset. Thank you for sharing and I hope your pain will resolve soon.

[@johnderizzo4784]

God bless you for sharing your story. I have recently been diagnosed with Tm and am awaiting further results from lab in the new year. Im struggling to come to terms with the diagnosis but I have faith and hope that I can fight this to the best of my ability.

[@pklmempk]

@@johnderizzo4784 John, my heart goes out to you. Your journey will be full of ups and downs and each time you accomplish a little victory you will be determined to keep moving forward. I was not able to turn my electric toothbrush on and off, open a pill bottle, hold my fork or cut my food, wash my hair in the shower, trim and file my nails, and tend to my toileting needs including getting up off the toilet. My husband who is 5 years older than I was having his own severe back issues when my attack hit me and I feared my disability would make his health worse. So, I was extremely motivated to work on my recovery to be more independent so I wouldn’t be such a burden to him. He has been a wonderful and understanding caretaker and now I am able to help HIM when he needs it. I still have a lot of trouble with handwriting and don’t have the strength to write a check with enough pressure to make the carbon copy so he does that for me. I still have skin sensory issues with heat and cold temperatures but I can’t change that. My gait and balance is still a bit off so I have to be careful when I’m turning around or reaching out for something. I tell you these things because I want you to realize how important it will be for you to continue your “home” therapy for regaining your strength and dealing with your pain. Folding king-size sheets and carrying a full laundry basket are difficult for me but I call it “therapy” so it’s worth the effort because household tasks have really helped me to regain my strength. It has been over a year since my diagnosis and people tell my I look great and are amazed that I have “fully” recovered. They can’t see what’s going on inside my body or my mind. And that’s ok because it makes me feel “normal” again. If your lab results can identify a cause for your TM be grateful that you know what caused the onset. Mayo Clinic was unable to identify a cause for me so I am always wondering if I will do something to trigger a relapse. My health providers have assured me that I didn’t do anything to bring on the initial attack and that there is a very small chance for relapse. I have been trying to find a TM support group but haven’t found one yet. I would be interested to hear from you when your results come back and how you are doing. Believe me, I mean it when I say I share your pain.

[@Papeone111]

Hi Linda, would you mind providing a general timeline with your recovery? How long did it take for you to be able to functionally use your arms again?

[@kelumpathirana8210]

The best teacher I have ever met in my life.♥️

[@CF-kj4pm]

I'm so happy you are covering this. I wish more providers were aware of TM as a disease & as a symptom of other conditions. TM is common in NMOSD( neuromyelitis óptica spectrum disorder)

[@yvonnemccullaghward361]

Thank you. I had TM 6 years ago T2-T4 idiopathic but initially diagnosed with a functional disorder as both my PCP and then ER doctor both said it was not neurological though my ability to walk was deteriorating and by time in ER I was paralysed from chest down. This lecture was still so helpful as it affirms the horrible aftermath of TM and then not treated for couple of weeks before MRI or steroids which was only treatment I ever received.

[@expansiveimprovements]

You are the bomb by the way I can’t get enough of the education you provide for free thank you for your time and your knowledge you share!!!!! You help me grow every time I watch you speak!!!

[@CecilyLivingBeyondtheBag]

Thank you so much for all your amazing videos! Your dedication and ability to explain complex physiological concepts is unmatched. ❤️

[@chastidyirving3680]

I’m

[@penelopenem]

I love that you had the whiteboard preset up to go through. Great way to keep myself on track and remind myself of what you talked about leading up. Nicely done!

[@sybilmclean6899]

Thanks

[@drahmed-pz3jl]

this was one lecture that covered from patho to physio to neuroanatomy!!!!! and TM as well so much correlations was impressive

[@MohsenDhafer]

pops was diagnosed last night, thanks teach, you're the best

[@someoneone6300]

you are amazing🥺 you've really simplified it

[@successchukwu7205]

Wow. Thanks sooooo much. You are really the true King of online medicine

[@mrsamandabernier]

Awesome as always. Thanks!

[@praxedesbautista9783]

Good day to you doctor ...so impressive ...my daughter in law is suffering so much with this transverse myelitis...I think it's already 9 years now and still she can't stand up and can't walk. I appreciate so much if you can help her doctor with the right medicines...hoping for your positive response ...she is here in Pangasinan, Philippines...please...she has 3 children and already 41 years old...

[@mimi0424]

I'm 45 and have had it since 2017. I'm in water therapy. Basically we do my therapy in a pool and it's helping so much. I can stand a min or do outside of the water. My goal is to walk again. I pray for your daughter. I hv 3 children as well. 2 married daughters ..one Grandson and (1)..7yr old son.

[@Singledaddy734]

The only thing she can do is constant physical therapy

[@emanueljohnston7092]

I currently have a mild case of this. It was explained so well and all my A&P knowledge came rushing back. It was refreshing understanding what you were saying.

[@calzone3843]

I was diagnosed in 2011 when I was 13. Paralysed me from my nipples down but doctors don't know why I'm not paralysed from my neck down. Was told my case was one of the worst cases ever recorded

[@mosesuzagare3262]

Thank you so much sir for this detailed explanation ☺️ I searched almost all of the web for such information and explanation but I found it here 😊❤

[@Sergiomaeseortiz]

This video is pure gold !

[@arizonablossom8635]

Thank you so much for this hard topic 🙏🏻😎 can you lecture in spinal cord compression verses stenosis please.

[@jcarlo331]

I feel your passion , brings back good memories when I mapped out endless physiological processes, lol , my instructor at UWF taught same way excellent work Sensei.

[@yamrotestifanos500]

Thank you very much Zac. you are the best♥︎♥︎♥︎

[@bombshellsurf]

You are amazing!!! Thank you for this

[@christianchryxtalker2238]

Wow thank you for the wonderful lecture. You didn't state the role of Physical therapy in the management or treatment of TM. Thank you once again. I really learnt a lot from this video.

[@amandaa1105]

WOW thank you sooo much for this!

[@abdoessam8634]

Awesome explanation as usual

[@tawhidakhan6051]

Thank you so much for the informative video🤗

[@FIRgirll]

One of my fav drummers had this (Jory jordinson), RIP ❤. Thanks for the video! :)

[@med8615]

I came here to comment just that. Joey's an absolute beast. RIP legend

[@rtariq9115]

Nice video with great quality explanations

[@mohammadawad5988]

very useful and illustrative lecture...i hope Allah appreciate your efforts... thank you very much

[@vijaykumarchormalle7013]

Your are one of the best teacher 🏅 ❤️❤️ lots of love from India ❤️ Sir please upload the video with respect to its subject.

[@tesfamariam4401]

Nice presentation... Best teacher!

[@dekabraham6660]

Very good teaching thanks

[@Jessicank]

My father has this! Thank you!!!!

[@sarfrazshah4078]

Thank you your videos are energetic

[@obiesielawrence7658]

Very beautiful as usual. Love u guys ninja nerds

[@soumyadip2100]

Your videos are super resourceful 😍 Please make a video on valvular heart diseases and murmur

[@ssameeh]

Thanks a lot Zach

[@murtazabohra5388]

Thank you Zach !!!!

[@sabita2252]

You nailed it man 👏🏻👏🏻

[@taylorcook3572]

SOOOOOOOOOOOO MUCH AMAZING INFORMATION YOURE AWESOME DAWG

[@muslimaqeel7085]

It's amazing man!

[@evapanelli1]

I was diagnosed with TM 9/1996. I spent 17 days in the ICU - almost died. Woke up paralyzed with movement only in my left arm. Later, I recovered, but was left with severe deficits. It’s a horrible illness and treatment of high doses of steroids made me much worse, as their side effects alone were horrid. I truly do not wish this illness on anyone because the symptoms of every patient varies in intensity and degree. I thank God I’m still here. The chronic pain is so very intense, there are days I am bed ridden and just cannot function at all. It takes it’s toll on your spirit, as well because of the intense pain, weakness and spastic reaction. I can’t grab things because everything drops out of my hands. Walking is cumbersome, as I cannot lift my legs to walk, causing tripping and falls - so I sit more than anything. I pray a cure - not a treatment, is found in my lifetime. I am 58 years old and life is challenging, yet I’m grateful to be alive. Zero meds ! Every single day is a gift.

[@jamessigrist9272]

Due to the timing of this videos release, I now slightly suspect that you are a slipknot fan at least to some extent. Made my day.

[@user-zx4mb3xv4p]

thanks a lot for this easy information about the etiology 😘😘😘😘😘😘

[@ShehanDyonisius]

Awesome Job

[@nagaratnamsuthakaran3639]

Thank you very much sir

[@mishamalghani7955]

Loved it!!!!

[@anisali9331]

So thankful

[@karlodomijan1811]

Great video!

[@slavomirslavov4564]

thanks Zach !

[@tiffanydaly601]

Last july 2021 i got diagnosed with trans verse from the covid vaccine and left me paralyzed for a while took about a lil more than 6 months to walk and be independent. Long story short, im doing more than i did before this happened. very interesting video

[@cindyvigil1376]

Hi Tiffany I have TM and we're you in any pain

[@cindyvigil1376]

Hi Tiffany, I have TM and we're you in any pain

[@kayleemack1958]

Very nice thank you.

[@thilinaalagiyawanna3680]

Thank You very much

[@talhayamak7176]

thank you so much

[@tarikbaykara]

That is fabulous

[@Jackmanis]

my story, March 2022, came home after playing softball. my feet felt kinda numb, then my legs started getting weak. I went to my PCP and did blood work. that came back fine. went to the chiropractor, he said probably my lumbar was messed up. I asked for an MRI. that showed some inflammation in my cervical and lumbar areas. Then I went to a spine specialist. he looked at my walking and immediately said it was neurological. he ordered an MRI which showed a legion on my t-5 area. meanwhile im getting numb from my belly down, and an electric sensation down my spine when I tilted my chin down. 2 weeks in I was using a walker, 2 weeks later I was in a wheelchair. my first neurologist did every blood test he could. I did 6 MRIs and a spinal tap. Plus a week of daily steroid infusions. he was leaning towards MS. I then saw another neurologist and he did the pinprick test. he ruled out MS and ALS (thank God). he finally mentioned Transverse myilitis. he offered the plasma transfusion but couldn't tell me how effective it would be,so we opted against that. It turns out that an old friend had the same thing last year. we shared the same symptoms. she recommended I do physical therapy, which I did. it's now been six months, I'm able to stand and walk a little with a walker. my numbness has lessened and my spasms have decreased. my friend was out of her wheelchair in 6 months. I will say that very few doctors know much about this. this video educated me more than my doctors did. I think for some people it just has to take its course along with PT. I can feel my body getting better. This is not a fun disease to deal with, but I'm glad I didn't have any bowel or urinary problems. if you have this, just hang there.

[@mukeshyadav-cv5zt]

Enjoyed it 👌👌👌

[@moyaserfathi7911]

Fantastic

[@drabdirahmanibrahin6021]

Thanks

[@Sunflower-vp8bc]

Loving the neuro!

[@Asjamali76]

Amazing

[@climbhigher4150]

Always the best

[@meryamlazrak1329]

thanks

[@barbarachristensen1111]

QQQ: Thank you for your video!! Question... In 2003, I was hospitalized for a week and the diagnosis was "Viral meningoencephalitis with components of transvers myelitis" and Urinary retention. In the end, thankfully, I came out of it fine. After watching your video about the cytokine storm that cause this... And, watching numerous videos on covid also causing cytokine storms... Is my immune system more susceptible to reacting by causing cytokine storms? Thank you... Just trying to figure out if I should be prepaired with certain meds, theropies if I get covid. Thanks for your professional opinion!

[@tubayounus5691]

May please make a vid. Based of differential diagnostics with INVENTED MD. How can I apply the acronym?

[@laradorren9648]

Currently recovering from TM at C2/C3. Had high dose of steroids and started feeling better. Recovery is slow but every day there are small improvements. To anyone going through this out there, seek medical help fast if you haven't already and as hard as it is, stay positive. Thanks for the video and helping me understand my condition better.

[@jcarlo331]

A dear friend of mine is now a quadriplegic, the transverse myelitis spans his entire cervical, any tips I could recommend to his providers? His is more likely autoimmune and idiopathic.

[@apostolismoschopoulos1876]

Greetings from Greece fellow doctors

[@wassimzurba3254]

Beautiful 🤩

[@joekennington3865]

I had the AstraZeneca vaccine in May 2021 and spent all of June in hospital. It took some head-scratching before being diagnosed with TM. I’m still recovering. What isn’t mentioned in the video, because I guess it’s well known, is just how slow the nerves are to repair, if indeed they do.

[@ayudereje7680]

thank you Neja nerd

[@amelmhmd9946]

Omg thank you

[@user-om3yl3rk4y]

Thank uuuuuu nInjaaaa

[@kizitonangabo149]

nice video. are there any difference in clinical presentation between tm and gbs

[@user-se6pe3mw3c]

Thanks sir 🙏

[@rafiqualislam2360]

Love you from Bangladesh 🇧🇩

[@steveh1460]

Is TM frequently misdiagnosed as early stage PD? Great teaching!👍

[@Dipstikk]

My mom passed away last night after dealing with transvestite myelitis for about 12 years.

[@areebawarraich3506]

U are superb.. Your skills are mind blowing 🥷✅🫀

[@hauwayusuf8175]

Superb

[@Princeheart90]

I m neurologist, its very interesting for me

[@yvonnemccullaghward361]

Glad you are learning..at last? Still mad at my TM not being diagnosed or treated on time then left to deal with the pain and disability

[@mimi0424]

I have Transverse Myelitis. I was diagnosed in the hospital (ER) after an infection in my knee replacement called Pseudomonas. I had been struggling in rehab to walk for abt 2 wks while I had the infection. I didn't know what I had till later...the hospital kept me for 10 months..I actually couldn't feel my legs..or anything from the chest down. I could breathe on my own and move my hands..thats it. I had myclonus shaking which I still have..I'm doing water therapy now and I can sit up..move my legs & stand for a bit. Of course the water I can do longer. My goal is to walk but if I can atleast Pivot I'll take it.

[@apostolismoschopoulos1876]

I hope as time passes your condition improves. Do not abondon the struggle you will get over it, you will be able to walk again! My best wishes from Greece.

[@NinjaNerdOfficial]

Rehab is never easy, nor fun, but it IS worth it! Keep at it!

[@mimi0424]

@@apostolismoschopoulos1876my husband's Grandfather was Greek. He passed in 2018 at the age of 90..and my best friend Labrini is as well..she visits often. I live in Delaware USA. Ty for your kind words. I am 45 & a Mom of 2 Married Daughters..1 Grandson who's 4..and 1 almost 8 yr old son..its worth it to keep trying and fighting.

[@mimi0424]

@@NinjaNerdOfficial you're absolutely right! My Neurologist is Jason Silversteen from Delaware he's amazing!

[@apostolismoschopoulos1876]

@@mimi0424 yes it is worth and you will recover completely! I am a 21 student from Thessaloniki and on June I'm finishing my computer science undergraduate and on December I'm taking medical school admission exams..

[@Hussain_Safaa]

Great!

[@granitabazaj7260]

Hi @ninja If the acute event happened 1+ year ago and you do a spinal tap now, would it still show elevated inflammation in the cerebral fluid? Or is it pointless to do a spinal tap unless it's soon after the initial event

[@3olgaxo177]

We love you❤️❤️

[@sunilmoktan838]

awesome

[@anisali9331]

Good

[@samuelepinetti7928]

Therefore can multiple sclerosis affect the lower motor neuron?

[@djelliott4524]

What a great breakdown. Mine hit just after a nasty bout of Shingles. Cramping, numbness, pins n needles...mine is at T9 can see it plain as day. Neurologist considers me lucky(as do I) that strenght is still up even on bad days. I opted out of the spinal tap b/c once we knew what it was(ruling out MS etc) we were told there was no "cure" and I was already 4.5 months out from first symptom. I sure hope that info was accurate. Does anyone have like deep inner "trembling"? Stomach issues? Higher anxiety than pre infliction? Even my abs, probably b/c the shingles and lesions were all at T9, spasms? Feels like heart palps sometimes too but I know it effects from the lesion down not up. Always looking for more information on treatments. Thank you 🙏🏻😘

[@882center]

I have went through all that. Including one-year Albert ex-mob treatment. And I feel worse today than when it all started. Do you have any other suggestions I'm hurting

[@rinkassley3983]

“Buttered up that toast it look good😏”😂😂😂

[@_f_6957]

I have been suffering with covid long haulers since last year. I know someone who got covid 10 days ago and almost overnight lost use of their legs. He was finally diagnosed with transverse myelitis which led me to research and came acrossthis video. Do you know if this is common with covid or have you heard of this happening in covid patients? We thought i had MS but nothing came back on the MRI. Im going to talk to my dr about transverse myelitis at my next appointment. Thank you for the video.

[@mrcoreynitro]

Any update?

[@Susiivr]

My father is also one of those patients who immediately after recovering from COVID, began feeling weaker and weaker until he could no longer walk. He was first diagnosed with GBS then after what seemed very long and difficult 7 months, he was diagnosed with Transverse Myelitis. I hope all is well for you both. God bless.

[@Sheslulu]

@@Susiivr Was your Dad vaccinated? With underlying medical issues? Currently AstraZeneca is seeing TM in those who received the vaccine.

[@Susiivr]

@@Sheslulu He wasn’t! He got vaccinated about 2-3 months after he was wrongfully diagnosed with GBS. His insurance only covered a few of his treatments & physical therapies, but as of now he has not received any other positive response or may I say, support. 😢

[@simonpatenaude2797]

Ive had covid on april 10 and had to be hospitalized with all the myelitis symptoms 2 weeks after testing positive. Male, 33, use to workout 5 days a week. Now my legs are constantly numbs and weak and i have this constant pressure in my chest and back. My hands are feeling wierd. Lost sensation from ribcage to feet. Hope this will go away sooner or later. At least i am still able to walk, but this change me.. I have been 6 days hospitalized After all the tests, 2 MRI, lumbar puncture and 50 blood test, doctor told me i have a myelitis… 2x Pfizer @&$%#% covid!!

[@JB-fl1gv]

The human body is incredible

[@joelcordeiro2079]

THANK YOU DOCTOR FOR YOUR VIDEO! People who suffer from this awful disease need proper explanation and hope! On August 30, 1996 I was in Canada and the day before I cleaned an extremely dirty filter to a portable air conditioner of which I'm sure some of the dust flew in the air and maybe I breathed in? The next morning I got up and had a lot of pain in my arms, but could barely move my arms and felt horrible. After a few minutes I felt like something was scanning / vibrating going downward from my nipples moving down my entire body. It was very odd. It was kind of like I was being electrically scanned, vibrating and going downward in my whole body. I was quickly taken to the hospital, maybe 20 minutes, I then lost the ability to move or feel anything. I was paralyzed from the nipple area downward. The doctors in Canada said I should be rushed by ambulance to the USA, Detroit from Windsor Ontario Canada becasue it was possible I had Guillian-Barre and my organs could shut down. After getting to the Detroit hospital, MRI's, scans and tests etc. were given, and I was diagnosed with TM and it affected in my Cervical area of the spinal cord. After a few days I was able to walk, but my arms and hands were limited in abilities. I was released, but had difficulty walking and using my arms and hands. I returned to California where I've lived for decades and still do. I was finally treated with Cortical Steroids and after a couple of days I felt that scanning downward feeling again, but did not recover any more than what I had already. I have a tremendous amount of pain which is mostly on my left side. The pain feels like I have Dry Ice on my left side. I burn and freeze at the same time. It also feels like an extreme Sun Burn, and I mean extreme! I also have Nephropathy in my feet. With a tremendous amount of push, by doing things with my hands and exercise, I've recovered about 90% of my abilities. But now when I do anything that requires effort, I sweat profusely. I do however live with Chronic pain, and I do have muscle spasms from time to time, but usually when I've over done it and push too hard. I've been on every medication you can think of which not one of them helps with the pain. The only medication I get relief from is Cannabis, but I can only use that during night because if I have to drive, of course I can't be under the influence of which I thoroughly agree. If it had not been for the Cannabis, with all the pain I live with, I think I would have ended my life long ago. I'm thinking that the pain I live with is caused by the damage to my Myelin Sheath in my spinal cord? I only with it could be repaired to get rid of this incredible pain that I have had for decades! I am available for anyone who suffers with this awful syndrome if you care to write.

[@jenifaahmed527]

May God give you patience to deal with it and may he reduce your pain and difficulties

[@wilsona8376]

Ok

[@31stoffl]

I heard that hot Sauna and Omega 3 fatty acid could repair the Nerves faster ;

[@modh1695]

love you from somalia :)

[@fayiscp7410]

Very urgend

[@AmyLuna33]

Hi, could you please explain to me how the infectious causes of the myelitis respond well to the cures of corticosteroids, given the fact that the corticosteroids have an immunosuppressive action?! I understand the part where the corticosteroids calm down the inflammation and its effects on the myelin sheath, but I don't understand the mechanism of dealing with the infectious agents. Thank you very much in advance and big thumbs up for all the amazing goodness you are doing in the world with your videos

[@-randychasechase2660]

The cavernous Hemangioma t2andt3 The burning and tightness also ice pick headache

[@gemmabanks851]

Omg, poopoo and peepee… literally made my whole day! 🤣🥰 xx

[@amypeterson8615]

I just met a 53 year old male with this. At the age of 21 he felt a sharp pain on his shoulder! Then he became paralyzed from the neck down and has been on a tracheotomy ventilator for 30+ years. It’s interesting to have watched this. His is idiopathic.

[@mimi0424]

I have it as well but luckily I am paralyzed from the waist down. I've gotten some things back though. I was diagnosed after an infection called Pseudomonas I had after a knee replacement in 2017. I wish other Dr's knew what this was bc I always hv to explain it. Actually Johns Hopkins has a clinic in Baltimore, Maryland.

[@sirifarstad9396]

Is this related to the backpain in covid 1st version?

[@saifhady8514]

مبدع

[@morgancalvi6675]

5:27...I don't know, what is that called?