There are other disorders that involve inflammation in the central nervous system, like these three.
Diagnosing multiple sclerosis (MS) is complicated, because the symptoms caused by inflammation in the central nervous system are found in several other neurologic conditions as well. That’s why it’s important to be seen by a specialist who understands these disorders’ nuances.
The following three conditions — all treated by the Vanderbilt Multiple Sclerosis Center — are also caused by inflammation in the central nervous system, but they involve different areas of the body are can arise from different causes.
Transverse myelitis
Transverse myelitis is a neurologic condition (one affecting the nerves) that occurs when the spinal cord becomes inflamed. This inflammation can damage myelin, the insulating material that covers your nerves. Loss of myelin often leads to spinal cord scarring, which blocks nerve impulses and results in physical problems.
What causes transverse myelitis?
Transverse myelitis is a relatively rare disease. It occurs most often in children ages 10 to 19 and in adults ages 30 to 39. But it can happen at any age, and to any gender or race. In some cases, the exact cause of transverse myelitis is unknown. In other cases, the inflammation that leads to transverse myelitis can result as a side effect from other health problems, such as:
- Lyme disease
- Syphilis
- Measles
- Viral infections
- Bacterial infections
- Fungal infections
- Parasites
- Immune system disorders
- Autoimmune disorders, such as lupus
- After a vaccine (very rarely)
What are the symptoms?
The symptoms of transverse myelitis can develop over several hours or days, or over a longer period of one to two weeks. Symptoms include:
- Back or neck pain
- Weakness in the arms or legs
- Abnormal feelings in the legs, such as burning, tingling or pricking
- Loss of bladder or bowel control
- Heightened sensitivity to touch
How is it treated?
No effective cure currently exists for transverse myelitis — but there are treatments to prevent or reduce permanent neurologic problems.
Treatments focus on relieving the inflammation and or infection that causes the symptoms. High doses of steroids are used to suppress the activity of the immune system and to decrease swelling and inflammation. Your health care provider may also recommend pain-relieving medicines like ibuprofen or acetaminophen, immune-suppressing medicines and other medicines that specifically target nerve pain. A procedure called plasma exchange therapy (plasmapheresis), which exchanges the plasma in your blood with special fluids that remove the antibodies and proteins causing the inflammation, may also be used.
Neuromyelitis optica
Neuromyelitis optica (NMO) is a rare autoimmune disease that affects the central nervous system. It’s also called neuromyelitis optica spectrum disorder (NMOSD) or Devic’s disease. Neuromyeltiis optic specifically affects myelin, mainly in the spinal cord and the optic nerves — the nerves that carry signals from the eyes to the brain. As a result, the disease can cause paralysis and blindness.
What causes neuromyelitis optica?
With this condition, your immune system attacks the myelin cells in your spinal cord and optic nerves. Neuromyelitis optica can begin anytime from childhood to adulthood, with two periods being most common: one in childhood and the other in adults in their 40s. Women are more often affected than men.
There are 2 types of NMO:
- Relapsing form, which has periodic flare-ups, with some recovery in between. This is the more common kind. Women are far more likely to have this form than men.
- Monophasic form, which involves a single attack that lasts a month or two. Patients may then be free from attacks for several years. Men and women get this type equally.
What are the symptoms?
- Pain in the eyes
- Loss of vision
- Weakness or numbness in the arms and legs
- Paralysis of the arms and legs
- Difficulty controlling the bladder or bowels
- Uncontrollable vomiting and hiccups
How is it treated?
Experts don’t consider this condition curable. But your health care provider can prescribe medicines or other treatments to reduce the effects of the disease and relieve symptoms. These may include:
- Corticosteroid medicines to halt the immune system’s effect on your nerves
- Immunosuppressant medicines
- Plasmapheresis
- Other treatments to address symptoms such as pain, and loss of bowel and bladder control
You may also need help to cope with blindness and paralysis.
Encephalitis
Encephalitis is inflammation of the brain, which leads to changes in neurologic function. It can result in various symptoms, including mental confusion and seizures.
What causes encephalitis?
Viruses — including measles, mumps, chickenpox, herpes simplex virus and rabies — are the leading cause of encephalitis. But it can also occur from:
- An infection caused by things that carry a disease, such as ticks (which can cause Lyme disease), mosquitoes (West Nile virus) and cats (toxoplasmosis)
- Bacteria
- Autoimmune conditions that can attack the brain. This is called autoimmune encephalitis. It can also occur when your body may be trying to fight cancer. Sometimes encephalitis can start before a person knows about the cancer.
What are the symptoms of encephalitis?
Encephalitis often follows a viral illness such as an upper respiratory infection. It may occur after a gastrointestinal (stomach or intestinal) illness that causes diarrhea, nausea or vomiting. Symptoms can vary. The most common symptoms of encephalitis include:
- Headache
- Mild flu-like symptoms (aches, fatigue, slight fever)
- Sensitivity to light
- A stiff neck
- Sleepiness or lethargy
- Increased irritability
- Seizures
- Changes in alertness, confusion or hallucinations
- Loss of energy
- Loss of appetite
- Unsteady gait
- Nausea and vomiting
- Personality changes
In severe cases, symptoms may include:
- Weakness or paralysis in the arms and legs
- Double vision
- Impaired speech or hearing
- Coma
These symptoms may look like other health problems. Always see your health care provider for a diagnosis.
How is encephalitis treated?
The key to treating encephalitis is early detection and quick treatment. A person with encephalitis needs to be watched closely in a hospital.
The goal of treatment is to reduce the swelling in the head and to prevent other related complications. Your health care provider may use medicines to control the infection, seizures, fever or other conditions. If the problem is from an immune attack, treatment to suppress the immune system is used. If underlying cancer is the cause, the cancer will be treated as well.
The Multiple Sclerosis Center at Vanderbilt University Medical Center evaluates and treats adults and children with multiple sclerosis and similar conditions. Learn more about the services offered by visiting the website or by calling 615-343-1176.
