Transverse Myelitis

Transverse myelitis is a neurological disorder caused by inflammation across both sides of one level, or segment, of the spinal cord. Attacks of inflammation can damage or destroy myelin, the fatty insulating substance that covers nerve cell fibers. The segment of the spinal cord at which the damage occurs determines which parts of the body are affected. This damage causes nervous system scars that interrupt communications between the nerves in the spinal cord and the rest of the body. Symptoms include a loss of spinal cord function over several hours to several weeks. Most suffer permanent impairments that affect their ability to perform ordinary tasks of daily living.

June 19, 2016 – Acute flaccid myelitis in the United States – August – December 2014: Results of nation-wide surveillance “Most experienced respiratory (81%) or febrile (64%) illness before limb weakness onset. MRI abnormalities were predominantly in the cervical spinal cord (103/118). All but one case was hospitalized; none died. CSF pleocytosis (>5 white blood cells/mm3) was common (81%). At CDC, one CSF specimen was positive for EV-D68 and Epstein-Barr virus by real-time PCR, although the specimen had >3,000 red blood cells/mm3.”…”There is some evidence to suggest that the nasal spray vaccine may not protect children against H1N1 viruses during the 2014-2015 season because the same H1N1 vaccine virus from the 2013-2014 vaccine is included in the 2014-2015 vaccine“…”Acute onset of limb weakness in children, CDC has been working with healthcare professionals and state and local health departments to investigate reports of children across the United States who developed a sudden onset of weakness in one or more arms or legs, MRI scans show an inflammation predominantly of the gray matter—nerve cells—in the spinal cord. This illness is now being referred to as acute flaccid myelitis. From August 2 to November 26, 2014, CDC has verified reports of 90 children in 32 states who developed acute flaccid myelitis that meets CDC’s case definition.” Comment: Mass campaigns usually start with fear.

May 21, 2014 – Two Cases Settled for Transverse Myelitis Clients: More devastating effects of the flu vaccine “Ward Black Law is pleased to announce that settlements have been earned for two clients who developed transverse myelitis after receiving the flu vaccine. Because they endured pain, suffering and numerous lifestyle changes, Mrs. Gore and Mrs. Corum each received compensation totaling approximately $200,000.”

November 10, 2011 – Acute disseminated encephalomyelitis presenting as fever of unknown origin: case report (full text) “Acute disseminated encephalomyelitis (ADEM) is an immune-mediated inflammatory disorder of the CNS characterized by a widespread demyelization that predominantly involves the white matter of the brain and spinal cord. The condition is usually precipitated by a viral infection or vaccination and is more frequent in children.”

June 2011 – Acute disseminated encephalomyelitis in children: differential diagnosis from multiple sclerosis on the basis of clinical course “There is no specific biological marker or confirmatory test. ADEM should be suspected in a child who develops multifocal neurologic abnormalities with encephalopathy (e.g., confusion, excessive irritability, or an altered level of consciousness), especially if onset occurs one to two weeks after a viral infection or vaccination.

April 2011 – Demyelinating disease and vaccination of the human papillomavirus “Conclusions:: Have been described seizures, autoimmune disorders such as Guillain-Barre syndrome, transverse myelitis, or motor neuron disease, probably adverse effects following immunization by HPV vaccine. So we suggest that vaccine may trigger an immunological mechanism leading to demyelinating events, perhaps in predisposed young.”

March 18, 2011 – Acute transverse myelitis following vaccination against H1N1 influenza: a case report (pdf) “Five days after the vaccination (February 7, 2010), he started feeling unwell and weakness of left leg. Gradually he developed motor and sensory impairment in both lower extremities and could not raise the arms, which evolved over 1 week, and finally resulted in flaccid paraplegia with retention of urine, fecal incontinence, and loss of sensation below T4 dermatomal level.”…”MRI revealed diffuse abnormal signals of the spinal cord between the cervical (at C4/5 level) and the thoracic cords (at T6 level) (Figure 1). He was therefore diagnosed as having acute transverse myelitis.”

October-December 2010 – Central nervous system inflammatory demyelinating disorders of childhood (full text) “Neurologic symptoms usually follow between 1 and 20 days of infectious illness or vaccination. Clinical spectrum of ADEM/CIS is wide with mild subclinical disease at one end and a fulminant presentation with seizure, coma and death secondary to hemorrhagic acute disseminated encephalomyelitis at the other end. It can involve cerebral hemisphere (hemiparesis, aphasia), brain stem (cranial nerve palsies, ataxia) and spinal cord (paraparesis with or without bowel and bladder involvement).”…“It is also associated with vaccination against influenza, measles, mumps, pertussis, tetanus, meningoccal disease, Japanese B, BCG and rabies; organ transplant and drugs like gold, serum administration.”

August 2010 – Longitudinally Extensive Transverse Myelitis Following Vaccination With Nasal Attenuated Novel Influenza A(H1N1) Vaccine (full text) “The negative serology results coupled with the negative bacterial, viral, and fungal culture results on the cerebrospinal fluid excluded the possibility of an infectious cause. There was no laboratory evidence of vasculitis or connective tissue disease. Having effectively eliminated the most probable causes for this patient’s condition, we attributed it to postvaccination TM following novel influenza A(H1N1) vaccination.”

November 2009 – Transverse myelitis and vaccines: a multi-analysis – “We have disclosed 37 reported cases of transverse myelitis associated with different vaccines including those against hepatitis B virus, measles—mumpsrubella, diphtheria—tetanuspertussis and others, given to infants, children and adults. In most of these reported cases the temporal association was between several days and 3 months, although a longer time frame of up to several years was also suggested. Although vaccines harbor a major contribution to public health in the modern era, in rare cases they may be associated with autoimmune phenomena such as transverse myelitis. The associations of different vaccines with a single autoimmune phenomenon allude to the idea that a common denominator of these vaccines, such as an adjuvant, might trigger this syndrome.”

June 16, 2009 – Acute Disseminated Encephalomyelitis Following Vaccination Against Human Papilloma Virus (full text) “We report a case of severe encephalitis evolving shortly after administration of a new vaccine against human papilloma virus (HPV) recently approved for the prevention of diseases caused by HPV types 6, 11, 16, and 18.

March 4, 2009 – Critical Illness Polyneuromyopathy in a Child With Severe Demyelinating Myelitis “Our patient was an 8-month-old Caucasian boy, previously healthy, who presented with flaccid paralysis of his superior limbs after a fall from his height. Three weeks earlier he had a cold, and 2 weeks before hospitalization he received a vaccine against influenza virus. At admission, he had decreased deep tendon reflexes of his superior extremities and required immediate intubation for respiratory failure due to respiratory muscle weakness. A cerebral magnetic resonance imaging study was normal, whereas spinal magnetic resonance imaging demonstrated swelling of the cervical spinal cord from C1 to T1 with a mass effect and with high signal intensity on T2 sequence located centrally.”…”Although historically considered extremely rare especially in children, recent reports in adults and children point to coexistence of peripheral nervous system autoimmune inflammation (Guillain-Barre´ syndrome) and acute autoimmune central nervous system demyelination (transverse myelitis, acute disseminated encephalomyelitis, etc), which is more frequent than previously thought.”

January-March 2009 
– Differential diagnosis of white matter diseases in the tropics: An overview (full text)

December 2008 – Post-vaccination encephalomyelitis: literature review and illustrative case.

November 2008 – HPV vaccine: a cornerstone of female health a possible cause of ADEM? “Referring to a recent publication on the efficacy and safety of a vaccine against infection with human papilloma virus (HPV) type 16 and 18, we report on a patient who developed acute disseminated encephalomyelitis (ADEM) following this vaccination, a 15-year old previously healthy girl presented to our hospital with new-onset headache, nausea, fever, vertigo and diplopia.

February 2008 – Acute Disseminated Encephalomyelitis: Current Understanding and Controversies (pdf) “A history of antecedent infection or vaccination may increase the likelihood of ADEM, but also occurs with greater frequency in patients with first presentation of MS. Therefore, a strict requirement of an antecedent infection or vaccination is neither specific nor sensitive for ADEM.”

December 2007 – Improvement of advanced postvaccinal demyelinating encephalitis due to plasmapheresis (full text) “In our case, we suggest that the patient acquired an acute demyelinating encephalitis in consequence of vaccination against HAV, HBV, diphtheria, tetanus and poliovirus. The multiple temporal white matter lesions in combination with seizures and amnestic disorder could also be consistent with a diagnosis of limbic encephalitis.”

April 2007 – Acute disseminated encephalomyelitis. “Acute disseminated encephalomyelitis (ADEM) is an immune-mediated inflammatory disorder of the CNS characterized by a widespread demyelination that predominantly involves the white matter of the brain and spinal cord. The condition is usually precipitated by a viral infection or vaccination.”

2005 – Acute Disseminated Encephalomyelitis (pdf) “It is often antedated, especially in children, by a febrile prodromal illness, such as infection (postinfectious encephalomyelitis), immunization (postvaccinal encephalomyelitis), exanthema, or even bee sting.”

June 2003 
– Myelitis. “Viral myelitis is now often diagnosed by specific polymerase chain reaction of the cerebrospinal fluid, for echovirus, Coxsackie virus, mumps virus, herpes simplex virus or varicella-zoster virus, but an autoimmune component may still be important. An anterior horn syndrome may be produced by the tick-borne encephalomyelitis virus. Severe ATM may also be a postinfectious or postvaccinal disorder [i.e. a partial acute disseminated encephalomyelitis (ADEM)]. Neuromyelitis optica, a combination of severe myelitis and optic neuritis, is often a manifestation of ADEM or systemic lupus erythematosus.”

June 2002 – Immunopathogenesis of acute transverse myelitis.History of acute transverse myelitis: Several cases of `acute myelitis’ were described in 1882, and pathological analysis revealed that some were caused by vascular lesions and others by acute in¯ammation. In 1922 and 1923, physicians in England and Holland became aware of a rare complication of smallpox vaccination: in¯ammation of the spinal cord and brain. Given the term `post-vaccinal encephalomyelitis’, over 200 cases were reported in those 2 years alone.”

Volume 246 Number 12, 1999 Combined acute disseminated encephalomyelitis and acute motor axonal neuropathy after vaccination for hepatitis A and infection with Campylobacter jejuni “We present the case of a 23-year old previously healthy man who had been suffereing from diarrhea for 3 weeks when he received a vaccination with a recombinant vaccine for hepatitis A (Havrix) because he was planning a holiday in the Far East.

September 1981 – Demyelinating diseases and the cerebrospinal fluid cytoproteinogram.

June 1981 – Myelopathies: behavior of cerebrospinal fluid cells and proteins “It is shown that changes in the CSF cyto-protein dual are more related to those found in multiple sclerosis and neuromyelitis optica when chronic primary myelitis is considered. In acute and sub-acute primary myelitis they are related to those found in post-vaccination, post-infection and post-intoxication myelopathies.”