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Suggest treatment for transverse myelitis

Answered by
Dr. Sudhir Kumar


Practicing since :1994

Answered : 5779 Questions

Posted on Tue, 21 Feb 2017 in Cancer
Question: My husband was diagnosed with Transverse Myelitis two weeks ago. He was walking fairly well at the time. He had 5 dats of IV steroids followed by oral steroids. The oral steroids ended last week. He began a plasma exchange last Friday and had another today. Beginning Friday, he walking became more compromised. He is barely able to walk today. He is seeing a neurologist, but Transverse Myelitis is rarely seen in our area. Should be be getting weaker with treatment and losing the ability to Walk?
Answered by Dr. Sudhir Kumar 52 minutes later
Brief Answer:
Treatment is going on correctly.

Detailed Answer:
Thank you for posting your query.

I am Dr Sudhir Kumar, Neurologist, and would try my best to help you.

I have noted your husband's clinical details. Based on this, his treatment is going along correct lines.

We see transverse myelitis very commonly (at least 1-2 patients every month). We also follow the same treatment regimen. First, intravenous methylprednisolone 1gram daily for five days. Those who do not respond, we also start plasma exchanges. We do 5-6 cycles either daily or on alternate days.

About 85-90% patients respond to the above treatment, however, 5-10% may deteriorate, even while on the treatment. We can continue treatment with plasma exchanges. MRI of spine should be repeated. If the MRI also shows worsening, then, other treatment options such as IVIG injections or rituximab should be considered.

I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.

Wishing you good health,

Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, XXXXXXX XXXXXXX
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