What is the prognosis?
Recovery from transverse myelitis usually begins within 2 to 12 weeks of the
onset of symptoms and may continue for up to 2 years. However, if there is no
improvement within the first 3 to 6 months, significant recovery is unlikely.
About one-third of people affected with transverse myelitis experience good or
full recovery from their symptoms; they regain the ability to walk normally and
experience minimal urinary or bowel effects and paresthesias. Another one-third
show only fair recovery and are left with significant deficits such as spastic
gait, sensory dysfunction, and prominent urinary urgency or incontinence. The
remaining one-third show no recovery at all, remaining wheelchair-bound or
bedridden with marked dependence on others for basic functions of daily living.
Unfortunately, making predictions about individual cases is difficult. However,
research has shown that a rapid onset of symptoms generally results in poorer
Physical therapists treat disabilities that result from motor and sensory impairments.
Their aim is to help patients increase their strength and endurance, improve coordination, reduce spasticity and muscle wasting in paralyzed limbs, and
regain greater control over bladder and bowel function through various
exercises. Physiatrists and physical therapists teach paralyzed patients techniques for using assistive devices such as wheelchairs, canes, or braces as effectively as possible. Paralyzed patients also learn ways to avoid developing painful pressure sores on immobilized parts of the body, which may lead to increased pain or systemic infection. In addition, physiatrists and physical therapists are involved in pain management. A wide variety of drugs now exist that can alleviate the pain that results from spinal cord injuries such as those caused by transverse myelitis. These include nonsteroidal anti-inflammatory drugs such as ibuprofen or naproxen; antidepressant drugs such as amitryptyline (tricyclic) and sertraline (a selective serotonin reuptake inhibitor); muscle relaxants such as baclofen or tizanidine, and
anticonvulsant drugs such as gabapentin, pregabalin, and carbamazepine.
Occupational therapists help individuals learn new ways to maintain or rebuild their independence by participating in meaningful, self-directed, goal-oriented, everyday tasks (occupations) such as bathing and dressing. They teach people how to function at the lightest level possible, by developing compensatory strategies, suggesting changes in their homes to improve safety (such as installing grab bars in bathrooms), changing obstacles in their environment that interfere with normal activity, and instructing on how to use assistive devices.