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What is the history of Transverse myelitis?

When was Transverse myelitis discovered? What is the story of this discovery? Was it coincidence or not?

History of Transverse myelitis

Transverse myelitis (TM) is a rare neurological disorder that affects the spinal cord. It is characterized by inflammation of the spinal cord, which disrupts the normal functioning of the nerve fibers. TM can cause a wide range of symptoms, including weakness, sensory disturbances, and loss of bladder and bowel control. The history of TM dates back to the late 19th century when it was first recognized as a distinct clinical entity.



The term "transverse myelitis" was coined by the German neurologist Heinrich Schultze in 1882. He described a series of cases characterized by acute inflammation of the spinal cord, resulting in paralysis and sensory loss below the level of the inflammation. Schultze's observations laid the foundation for the understanding of TM as a distinct disorder.



Over the years, researchers and clinicians have made significant progress in understanding the causes, diagnosis, and treatment of TM. In the early 20th century, it was discovered that TM could be associated with various infectious agents, such as viruses and bacteria. This led to the recognition of post-infectious TM as a specific subtype of the disorder.



One of the key milestones in the history of TM was the identification of its association with multiple sclerosis (MS). In the 1940s, it was observed that some individuals with TM went on to develop symptoms consistent with MS, a chronic autoimmune disease that affects the central nervous system. This discovery highlighted the link between TM and MS, suggesting that they may share common underlying mechanisms.



Advances in medical imaging techniques, such as magnetic resonance imaging (MRI), have played a crucial role in the diagnosis and understanding of TM. In the 1980s and 1990s, MRI became widely available, allowing for detailed visualization of the spinal cord and identification of inflammatory lesions characteristic of TM. This led to improved diagnostic accuracy and a better understanding of the pathophysiology of the disorder.



Research into the causes of TM has revealed a diverse range of triggers. In addition to infections, TM can be associated with autoimmune diseases, such as systemic lupus erythematosus and neuromyelitis optica. It can also occur as a complication of vaccinations, exposure to certain medications, or as a result of spinal cord injury. However, in many cases, the exact cause of TM remains unknown, and it is considered idiopathic.



The treatment of TM has evolved over time, with a focus on reducing inflammation, managing symptoms, and promoting recovery. High-dose corticosteroids, such as methylprednisolone, are commonly used to suppress the immune response and reduce inflammation in the spinal cord. Other immunosuppressive therapies, such as intravenous immunoglobulin and plasma exchange, may be considered in severe or refractory cases.



Rehabilitation plays a crucial role in the management of TM. Physical therapy, occupational therapy, and other rehabilitation interventions aim to improve mobility, strength, and functional abilities. Management of bladder and bowel dysfunction is also an important aspect of care.



Prognosis varies widely among individuals with TM. Some individuals experience a complete recovery, while others may be left with significant disabilities. The extent and speed of recovery depend on various factors, including the severity and location of the spinal cord inflammation, the underlying cause, and the timeliness of treatment.



In recent years, there have been significant advancements in the understanding of TM, particularly in the field of immunology. Ongoing research aims to unravel the complex immune mechanisms involved in the development of TM and identify targeted therapies to improve outcomes.



In conclusion, the history of transverse myelitis spans over a century, from its initial recognition as a distinct clinical entity to the current understanding of its diverse causes and treatment options. While much progress has been made, there is still much to learn about this rare neurological disorder. Continued research and collaboration among clinicians and scientists hold the promise of further improving the diagnosis, treatment, and prognosis of TM.


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15 answers
The earliest reports describing the signs and symptoms of transverse myelitis were published in 1882 and 1910 by the English neurologist Henry Bastian.

In 1928, Frank Ford noted that in mumps patients who developed acute myelitis, symptoms only emerged after the mumps infection and associated symptoms began to recede. In an article in The Lancet, Ford suggested that acute myelitis could be a post-infection syndrome in most cases (i.e. a result of the body's immune response attacking and damaging the spinal cord) rather than an infectious disease where a virus or some other infectious agent caused paralysis. His suggestion was consistent with reports in 1922 and 1923 of rare instances in which patients developed "post-vaccinal encephalomyelitis" subsequent to receiving the rabies vaccine which then was made from brain tissue carrying the virus. The pathological examination of those who had died from the disease revealed inflammatory cells and demyelination as opposed to the vascular lesions predicted by Bastian.

Ford's theory of an allergic response being at the root of the disease was later shown to be only partially correct, as some infectious agents such as mycoplasma, measles and rubella were isolated from the spinal fluid of some infected patients, suggesting that direct infection could contribute to the manifestation of acute myelitis in certain cases.

In 1948, Dr. Suchett-Kaye described a patient with rapidly progressing impairment of lower extremity motor function that developed as a complication of pneumonia. In his description, he coined the term transverse myelitis to reflect the band-like thoracic area of altered sensation that patients reported. The term 'acute transverse myelopathy' has since emerged as an acceptable synonym for 'transverse myelitis', and the two terms are currently used interchangeably in the literature.

The definition of transverse myelitis has also evolved over time. Bastian's initial description included few conclusive diagnostic criteria; by the 1980s, basic diagnostic criteria were established, including acutely developing paraparesis combined with bilateral spinal cord dysfunction over a period of <4 weeks and a well-defined upper sensory level, no evidence of spinal cord compression, and a stable, non-progressive course. Later definitions, were written in order to exclude patients with underlying systemic or neurological illnesses and to include only those who progressed to maximum deficit in fewer than 4 weeks.

Posted Aug 16, 2022 by Transverse Myelitis Folks Blue Crew
How long has TM been around? Reports in the medical literature of “acute myelitis” date back to 1882 and are credited to Dr. H.C. Bastain, an English neurologist (Bastain, Quain’s Dictionary of Medicine, 1st Edition, 1882). He described several cases of acute myelitis resulting in “softening of the spinal cord.” He presented the pathologic findings of several autopsies from patients who died of the myelitis and divided the cases into those that he thought were due to “thrombotic events to blood vessels supplying the spinal cord” and those that were due to acute inflammation. A thrombotic event means a “stroke” of the spinal cord in which a clot forms in one of the spinal arteries, thus depriving the spinal cord of oxygen and causing death of nerve cells in that area. Most of these cases were due to syphilis (syphilitic endarteritis – meaning that the syphilis causes an inflammation of small arteries as they enter the spinal cord). The ‘inflammatory’ cases were postulated to be due to an infectious or an allergic mechanism. (Unfortunately, 118 years later we don’t have a markedly improved concept of inflammatory transverse myelitis).
Dr. William Spiller at the University of Pennsylvania published a report in 1909 detailing thrombosis of the cervical anterior spinal artery and proposed strongly that virtually all cases of acute myelitis are due to blood clots, not inflammation (we now know that either blood clots or inflammation may cause TM). His patient in that report (named John W.) was an employee of the Philadelphia General Hospital who was required one morning to lift 100-pound blocks of ice with assistance of another man. (These blocks were then transported to each patient’s room as “air conditioning” and to provide cool washcloths). Shortly after lifting the fourth ice block, John W. “began to have a sensation of coldness and pain between the shoulders.” He then noted “stiffness, then lower limb numbness and weakness.” He became paralyzed by the next day, and despite utilization of an iron lung ventilator, John W. died shortly thereafter. Autopsy of his spinal cord showed a blood clot in the cervical anterior spinal artery, and it was proposed that the lifting had caused the clot to form.
In 1922 and 1923, physicians in England and Holland became aware of a rare complication of smallpox vaccination: inflammation of the spinal cord and brain (reviewed by Dr. T. M. Rivers, JAMA, 1929). Given the term post-vaccinal encephalomyelitis, over 200 cases were reported in those two years alone. Pathologic analyses of fatal cases revealed inflammatory cells and demyelinization rather than the vascular pathology noted above. It was interesting to note that the ratio of cases to vaccination was 1:50,000 in England and 1:5,000 in Holland. England carried out all its smallpox inoculations in children less than one year of age, giving rise to the notion that “infants are relatively insusceptible to post-vaccinal encephalomyelitis.” What was perplexing then (and continues to be perplexing today) is that family members got the identical vaccine (or in many cases today got the same “cold”), but only one member of the family developed acute myelitis.
Dr. Frank Ford reported in 1928 (Ford, F.R.: Bulletin of Johns Hopkins Hospital, 1928) his hypothesis that many cases of acute myelitis are post-infectious rather than infectious in cause. His reasoning was that in many cases of acute myelitis associated with mumps, the patients’ “fever had fallen and the rash had begun to fade” when the myelitis symptoms began. He proposed the idea, therefore, that it was an “allergic” response to the virus rather than the virus itself that caused the spinal cord damage. Dr. Ford also noted that “neuroparalytic” accidents had been noted even dating back to 1887. Specifically, many patients had become paralyzed following rabies virus vaccination. The paralysis was not found to be due to the rabies virus itself, but rather to the repeated inoculation of patients with brain tissue carrying the virus. Dr. Ford was not aware of the functions of the immune system, but we would conclude today that the immune response generated against the brain tissue then attacked the spinal cord and caused the paralysis.
Several cases were then reported over the next two decades showing that though Dr. Ford may be right in some instances, several infectious agents can directly cause acute myelitis, notably measles and rubella viruses (Morris and Robbins, Journal of Pediatrics, 1943; Senseman, Archives of Neurology and Psychiatry, 1945). It was in 1948 that Dr. Suchett-Kaye, an English neurologist at St. Charles Hospital in London, utilized the term “acute transverse myelitis” (Suchett-Kaye, The Lancet, 1948) in reporting a case of acute TM complicating pneumonia. Though not indicated in the initial report, the addition of ‘transverse’ reflected the common clinical finding that patients reported a ‘band like’ horizontal area of altered sensation on the neck or torso. Below this area, sensation was absent or at least altered and was associated with bowel and bladder dysfunction and weakness. Above this area, patients were normal. We now know by looking at MRIs of the spinal cord that this reflects inflammation or injury in a particular area of the spinal cord, with uninjured nerve cells above this area.
Since that time, the syndrome of progressive paralysis due to spinal cord inflammation has been known as transverse myelopathy or transverse myelitis. What is the difference between ‘myelopathy’ and ‘myelitis?’ Technically, any ‘.itis’ means ‘inflammation’: ‘Arthritis’ means inflammation of the arthus (joint); ‘sinusitis’ means inflammation of the sinuses, for example. Inflammation means that the immune system is activated and recruited to the area, potentially causing damage. But several of the cases we see today may be due to vascular events like thrombosis, hemorrhage or dural AV fistulas (abnormal collection of blood vessels on the surface of the spinal cord). These are not truly inflammatory conditions since the clinical events are due to blockage of blood flow. Therefore, we utilize the term first introduced by Paine and Byers (American Journal of Diseases in Children, 1953) of ‘transverse myelopathy.’ This is an all inclusive term which indicates any focal injury to the spinal cord, whether it be infectious, post-infectious, vascular, traumatic or the dreaded idiopathic (which is a fancy term to mean that we do not know what caused the myelopathy).

Posted Jul 24, 2017 by Hagen 2730
the earliest reports date back to the 1880's

Posted Jul 25, 2017 by Mindy 2000
It was first discovered in 1882, however the screening and diagnosing has since been improved.

Posted Jul 25, 2017 by Conrad 2200
Reports in the medical literature of “acute myelitis” date back to 1882 and are credited to Dr. H.C. Bastain, an English neurologist

Posted Oct 6, 2017 by Chuck 2000
The earliest reports describing the signs and symptoms of transverse myelitis were published in 1885 and 1910 by Bastian.
Suchett-Kaye first coined the term transverse myelitis in 1948

Posted Nov 30, 2017 by mikado54mark 3150
Acute Myelitis was first mentioned by an English neurologist in 1882 and most of the early cases were thought to be caused by syphilis. In the 1920’s doctors became aware of a complication to the smallpox vaccination which caused inflammation of the spinal cord/brain and over 200 cases were reported. The term Transverse Myelitis was not used until the 1850’s by Paine & Byers

Posted Feb 27, 2018 by Gill 1800
Prior to 1994, TM had not really been identified as a disease condition. Since then much has been learned, particularly through the efforts of the TM Clinic at John Hopkins Medicine.

Posted Jun 1, 2018 by Clay Garner 2500
I can only refer to wikipedia:
First reported in 1882 and 1910 by English Neurologist Henry Bastian.The term acute Transverse myelitis was first used by English Neurologist in 1948.

Posted Jun 1, 2021 by Gary 3550
The earliest reports describing the signs and symptoms of transverse myelitis were published in 1882 and 1910 by the English neurologist Henry Bastian.

In 1928, Frank Ford noted that in mumps patients who developed acute myelitis, symptoms only emerged after the mumps infection and associated symptoms began to recede. In an article in The Lancet, Ford suggested that acute myelitis could be a post-infection syndrome in most cases (i.e. a result of the body's immune response attacking and damaging the spinal cord) rather than an infectious disease where a virus or some other infectious agent caused paralysis. His suggestion was consistent with reports in 1922 and 1923 of rare instances in which patients developed "post-vaccinal encephalomyelitis" subsequent to receiving the rabies vaccine which then was made from brain tissue carrying the virus. The pathological examination of those who had died from the disease revealed inflammatory cells and demyelination as opposed to the vascular lesions predicted by Bastian.

Ford's theory of an allergic response being at the root of the disease was later shown to be only partially correct, as some infectious agents such as mycoplasma, measles and rubella were isolated from the spinal fluid of some infected patients, suggesting that direct infection could contribute to the manifestation of acute myelitis in certain cases.

In 1948, Dr. Suchett-Kaye described a patient with rapidly progressing impairment of lower extremity motor function that developed as a complication of pneumonia. In his description, he coined the term transverse myelitis to reflect the band-like thoracic area of altered sensation that patients reported. The term 'acute transverse myelopathy' has since emerged as an acceptable synonym for 'transverse myelitis', and the two terms are currently used interchangeably in the literature.

The definition of transverse myelitis has also evolved over time. Bastian's initial description included few conclusive diagnostic criteria; by the 1980s, basic diagnostic criteria were established, including acutely developing paraparesis combined with bilateral spinal cord dysfunction over a period of <4 weeks and a well-defined upper sensory level, no evidence of spinal cord compression, and a stable, non-progressive course. Later definitions, were written in order to exclude patients with underlying systemic or neurological illnesses and to include only those who progressed to maximum deficit in fewer than 4 weeks.

Posted Aug 17, 2022 by Kevin Weilacher 3420
It was first described in 1882 and 1910. The term, Transverse Myelitis was coined in 1948.

Posted Aug 17, 2022 by gloria_kazan 7450
Translated from spanish Improve translation
The acute transverse myelitis is inflammation that affects the spinal cord in its entire width (transversely), thereby blocking the transmission of nerve impulses that enter or leave the spinal cord.

The disease develops in people who have certain disorders, such as multiple sclerosis, neuromyelitis optica, Lyme disease or lupus, or in those taking certain drugs.

People have back pain sudden and they feel a band of tightness around the affected area, sometimes followed by severe symptoms such as paralysis.

MRI can help to establish the diagnosis, but it is necessary to have a lumbar puncture.

Around a third of people recover, about one third continue to have some problems and the remaining one-third recover very little.

The cause is treated if possible, and the treatment includes corticosteroids and sometimes plasmapheresis.

It is estimated that, in the united States, acute transverse myelitis affects about 1,400 people each year. In addition, it is believed that approximately 33 000 people have some type of disability due to the disease. The entire width of one or more areas of the spinal cord, usually in the chest (thoracic area) becomes inflamed.

It is unknown what triggers acute transverse myelitis, but may be the result of a reaction autoimmune in which the immune system recognizes erroneously the body's tissues as if they were foreign and produces antibodies that attack tissues and damage them. In case of acute transverse myelitis, the injured tissues are found in the spinal cord. The disease develops during the following processes:

Multiple sclerosis (most frequent)

Neuromyelitis optica, a disease that also causes visual problems and appears and disappears

Certain bacterial infections (such as Lyme disease, syphilis, or tuberculosis)

Inflammation of the blood vessels (vasculitis), including lupus (systemic lupus erythematosus)

Tick-borne encephalitis virus (an infection of the brain and its surrounding tissues)

Use of certain drugs, anti-parasitic or anti-fungal

Intravenous injection of heroin or use of amphetamines

Sometimes develops after a mild viral infection or a vaccination.

Posted May 29, 2017 by Leandro 2200
Translated from spanish Improve translation
I don't know the history of this disease

Posted Aug 8, 2017 by Dani 2000
Translated from spanish Improve translation
We don't know the story of how it was discovered

Posted Nov 8, 2017 by Lorena 3050

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