Myelitis

Myelitis is an inflammation of the spinal cord, usually an exciting white and gray matter; With transverse myelitis lesion is limited to several segments.

Etiology, pathogenesis. Neurotropic viruses or neuro-allergic reactions in vaccinations or demyelinating processes, less often pyogenic flora with spinal injuries or common infections (meningococcal sepsis, etc.). In the lesion, usually in the lower thoracic department, there are edema, hyperemia, a lot of thrombosed vessels with perivascular inflammatory foci.

Symptoms, course. The onset is acute or subacute, often accompanied by an increase in temperature. There is intense pain at the level of the lesion, followed by a paralysis of the underlying parts of the trunk and extremities. A complete or partial loss of sensitivity is noted from the lesion level. There is a breakdown in the function of the pelvic organs. Soon Babinsky's symptom appears. In cerebrospinal fluid, hyperalbuminosis and pleocytosis (in the absence of a block).

Acute demyelinating polyradiculoneuropathy Guillain-Barre unlike myelitis is not accompanied by conductive disorders. From myelitis, epiduritis is almost indistinguishable; Decisive in the epiduritic block in the test of Kvekkenstedt and in myelography. The spinal stroke in the clinical picture resembles myelitis, but differs in the normal composition of the cerebrospinal fluid and the localization of the lesion, usually in the basin of the anterior spinal artery, whereas in the myelitis the entire diameter of the spinal cord, including the posterior columns, is usually damaged.

In some cases, the symptoms of myelitis are combined with neuritis of the optic nerve, forming a syndrome of opticomelitis or Devik's disease, close to demyelinating diseases.

Treatment. Large doses of glucocorticosteroids-up to 80-120 mg predneenolone per day inside, 1000 mg metipreda drip for 3-5 days with the subsequent transition to oral intake. Skin care and monitoring of bladder function. Antibiotics for the prevention of intercurrent infections.

Forecast. Pyogenic myelitis with an ascending course usually terminates lethal, but a timely connection to a respirator can save a patient with paralyzed respiratory muscles. With a gross damage to the diameter of the brain, persistent paraplegia remains. In more light cases, it is possible to restore spinal functions, often quite significant.