Myelitis. Acute myelitis: diagnosis and treatment What is inflammation of the spinal cord

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Classification

Depending on the degree of prevalence of the pathological process, there are:

• Limited (there is a certain focus).
• Diffuse (common) - inflammation to one degree or another captures the entire spinal cord.
• Multifocal - there are more than 2 foci in different areas.
• Transverse myelitis occurs when inflammation captures several adjacent segments.

• bacterial;
• viral;
• traumatic;
• toxic;
• post-vaccination;
• radiation;
• idiopathic (when the cause cannot be established).

Causes of myelitis of the spinal cord

• bacterial myelitis (infectious myelitis) occurs with purulent meningitis. The most common causative agent of inflammation is meningococcal infection. Also, this type of myelitis can be caused by pale treponema (in severe forms of syphilis), pathogens such as brucellosis, typhoid fever and measles. A pathogenic microorganism can enter the spinal cord both with a spinal injury and with blood flow from another focus of infection in the body.
• Viral myelitis occurs in 20-40% of cases of inflammation of the spinal cord. The most commonly isolated viruses in the disease are the Coxsackie group, ECHO, rabies virus, influenza, etc.
• Traumatic myelitis occurs with closed or open injuries of the spine, against which a bacterial or viral infection joins.
• Toxic myelitis due to poisoning with chemicals such as mercury, lead, etc. Often, in addition to the symptoms of inflammation of the spinal cord, there is also a clinic of damage to the spinal roots and nerves.
• Post-vaccination myelitis has an allergic nature, developing after vaccination in sensitized individuals (predisposed to such complications).
• Radiation myelitis most often develops during radiation therapy of malignant tumors of the esophagus, larynx, pharynx, as well as during irradiation of metastases in the retroperitoneal lymph nodes.
• Acute idiopathic transverse myelitis takes place in the case when it is not possible to find the cause that caused the inflammation. In this situation, the main role in the occurrence of the disease is given to the immune system, the occurrence of a failure in which leads to an "attack" of the brain tissue with its own cells.

Main symptoms

Further manifestations will depend on the type of disease.

Acute focal myelitis

Acute disseminated (common) myelitis

Subacute and chronic myelitis

Following the pain syndrome, sensitivity disorders, paralysis develop, and the work of the pelvic organs suffers. Paralysis at the beginning of the disease is sluggish, but a spasm gradually appears and pathological reflexes occur.

Very often, in subacute and chronic myelitis, blood supply and tissue nutrition are disturbed, as a result of which bedsores quickly form.

Stagnation of urine in the urinary organs, as well as bedsores, can serve as entry gates for the penetration of infection, resulting in blood poisoning.

Radiation myelitis

Course of the disease

Diagnostics

Myelitis treatment

• Hospitalization is required.
• Allergic, viral and idiopathic forms of the disease require the appointment of large doses of hormonal drugs (up to 120 g of prednisolone per day). The duration of such treatment depends on the rate of improvement.
• Antibiotics are prescribed from the first days of treatment, even if no bacteria were found in the cerebrospinal fluid. This is a necessary measure to prevent the development of superinfection (secondary infection). Antibacterial agents are prescribed in the maximum allowable doses.
• Diuretics (Furosemide, Mannitol, etc.).
• With urinary retention, constant emptying of the bladder to prevent stagnation of urine.
• Skin care for the prevention of bedsores.
• With a strong pain syndrome, narcotic or non-narcotic analgesics are prescribed.
• When the body temperature rises above 38.5 o C give antipyretics.
• After the acute process subsides, vitamins are prescribed, and rehabilitation measures are also carried out: physiotherapy exercises, massage, physiotherapy procedures.

Myelitis in dogs

Manifestations depend on the severity of the disease and the extent of brain damage. The disease begins with a change in gait, seizures. Then paralysis of the hind limbs is observed, bedsores form due to immobility, and the animal dies.

Treatment. The dog is placed on a soft bed and periodically turned over to prevent the formation of bedsores. Physiotherapy is done on the lumbar region: solux, UHF, dry heat. A massage of the hind limbs is prescribed. With paralysis - strychnine and dibazol. In violation of bowel movements, a cleansing enema is done every few days.

Myelitis of the spinal cord is an inflammatory process that develops in individual segments, roots, vertebral bodies, processes and other structures of the spinal column. It is quite rare, but it is characterized by serious complications.

Types of disease

Depending on the localization of the infectious focus and the characteristics of the course of the pathological process, there are several types of myelitis.

The main classification is based on the intensity of the clinical manifestations of the disease. In this regard, acute myelitis, subacute and chronic are distinguished.

Most often, the pathology develops in the thoracic part of the spine, the lumbar and cervical regions are affected much less frequently. Myelitis can be localized in one segment, surrounding structures, or spread to different parts of the spinal cord. There are the following types of diseases:

1. Limited, or focal. Does not go beyond 1 segment.
2. Multifocal, scattered or disseminated. Areas of inflammation of unequal intensity are found in different parts of the spinal cord.
3. Transverse. The disease covers several adjacent segments within the same department.
4. Diffuse, or widespread. The entire spinal cord is involved in the pathological process. At the same time, the intensity of inflammation differs in the thoracic, cervical and other parts of the spine.

Causes of the disease

Myelitis can be primary or secondary. The primary form develops under the influence of neurotropic viruses and is quite rare. Another option is more common, since the reasons for its occurrence are very diverse. These include:

The likelihood of pathology increases in people with weakened immunity, after hypothermia, overheating, physical or mental overstrain and other factors.

Characteristic features

What is myelitis? This is inflammation of the spinal cord, respectively, the main clinical manifestations are the symptoms of the inflammatory process:

• pain;
• edema;
• skin redness;
• local increase in temperature;
• mobility disorder.

The severity of the symptoms depends on the location of the pathological focus and its prevalence.

Myelitis is characterized by the presence of a prodromal period during which patients complain of weakness, a slight increase in body temperature, pain and aching muscles.

Acute transverse myelitis is characterized by rapid progression. The human condition is rapidly deteriorating. The temperature rises to febrile numbers, there are pains in the thoracic spine. Paresthesia develops - weakness of the lower extremities, a feeling of crawling, numbness. Decreases and even disappears tactile sensitivity on the hands and feet. The normal functioning of the pelvic organs is disrupted. A person is not able to fully control the work of the bladder and intestines. The occurrence of paralysis of the lower extremities is not excluded.

Widespread myelitis is characterized by the appearance of pathological foci in all parts of the spine. At the same time, clinical manifestations differ on the right and left side of the body. Violated or even completely absent deep reflexes.

In subacute and chronic myelitis, the signs of the disease are vague. Symptoms largely depend on the level of the spine where the inflammation is localized. When the lumbar or thoracic region is affected, paresthesias develop in the lower extremities, when the neck is involved in the pathological process, sensitivity is disturbed not only in the legs, but also in the arms. Lack of treatment leads to the development of paralysis. Their danger lies in poor blood circulation and tissue nutrition, as a result of which there is a high risk of developing bedsores.

The disease most often occurs soon after exposure to a provoking factor - trauma, an infectious or viral disease, the introduction of immunobiological drugs, etc. And only with the radiation variant of myelitis, the pathology develops 6-12 months later, and in some cases even 2 years after exposure to radioactive radiation . This makes it much more difficult to determine the cause.

Diagnostics

To make a diagnosis of myelitis, one examination and collection of anamnestic data is not enough. A comprehensive and comprehensive examination is required, including the use of laboratory tests and instrumental methods.

Diagnosis of the disease includes a neurological examination. The doctor determines the boundaries of loss of sensitivity. An important role is played by the presence of violations of the conductive type (horizontal direction). Assesses muscle tone and strength of the limbs, the preservation of deep reflexes.

In the general blood test, an increase in the level of leukocytes, an erythrocyte sedimentation rate, the presence of C-reactive protein and fibrinogen is determined. If an infectious or viral etiology of the disease is suspected, antibodies to certain pathogens are determined in the blood. There are signs of inflammation in the cerebrospinal fluid.

Of the instrumental diagnostic methods, the following procedures are shown:

1. ENMG (electroneuromyography). Allows you to assess the conductivity of nerve impulses, to establish the level of disturbances and the localization of the pathological process.
2. MRI. Gives you the opportunity to get detailed layered images of the spinal cord. With their help, it is easy to determine the boundaries of the infectious focus.

Medical therapy

Treatment of myelitis primarily depends on what led to the development of the disease. The complex therapeutic scheme includes symptomatic drugs, the purpose of which is to improve the patient's condition.

In the treatment of the disease, the following groups of drugs are used:

1. Antibacterial drugs of a wide spectrum of action in maximum doses. They are used regardless of what caused the inflammation of the spinal cord. This will help prevent the attachment of a secondary infection and its spread through the structures of the spinal cord.
2. Antiviral drugs of systemic action. Herpetic myelitis requires long-term use of these agents.
3. Glucocorticosteroids. They have powerful anti-inflammatory properties that will help relieve inflammation and improve the well-being of the patient. In allergic myelitis, it has an antihistamine effect. The duration of hormone therapy is determined by the attending physician individually, depending on the patient's condition.
4. Antipyretics. Used when body temperature rises above 38°C. Basically, drugs based on Paracetamol or Ibuprofen are used in age doses.
5. Analgesics. With severe pain syndrome, medications from the NSAID group are included in the treatment. If there is no positive effect from their use, a decision may be made on the advisability of using narcotic analgesics.
6. Immunostimulants. Effectively strengthen the immune system and increase the body's own defenses.
7. Muscle relaxants. Remove muscle tone and promote muscle relaxation.
8. Diuretics. Myelitis is accompanied by dysfunction of the pelvic organs. The use of diuretics will prevent stagnation of urine in the bladder and the development of an inflammatory process in the urinary tract.

Patient care and extra activities

Proper patient care plays an important role in the successful treatment of the disease. In the absence of natural urination, it is necessary to carry out catheterization of the bladder. The patient should be regularly turned over and treated with antiseptic agents on areas of the body that are subjected to the greatest stress. Carefully straighten the bed linen so that there are no wrinkles. Such measures will help prevent the development of bedsores.

Treatment with folk remedies can provide effective assistance in the treatment of the disease. However, any method should be previously coordinated with the attending physician in order to prevent the deterioration of the patient's well-being.

The recovery of the patient takes quite a long time. During this period, it is necessary not only to take prescribed medications, but also to undergo a course of physiotherapy procedures. Physical therapy should not be neglected. Regular exercise will help strengthen muscles and restore tone. Massage gives good results.

What can the disease lead to?

The prognosis after the disease depends on the degree of damage to the spinal cord and the location of the pathological focus. The most dangerous is upper cervical myelitis, which most often leads to death. The occurrence of inflammation in the thoracic or lumbar region threatens the development of paralysis of the lower extremities and complete disability of the patient.

The highest chances of a person recovering from myelitis are observed with timely medical care. If the patient went to the doctor at the stage of loss of sensation in the limbs, the percentage of complete recovery will be much lower.

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Acute myelitis

What is Acute Myelitis -

Myelitis- inflammation of the spinal cord, in which both white and gray matter are affected.

What provokes / Causes of Acute myelitis:

Allocate infectious, intoxication and traumatic myelitis. Infectious myelitis can be primary, caused by neuroviruses (Herpeszoster, poliomyelitis, rabies viruses), due to tuberculous or syphilitic lesions. Secondary myelitis occurs as a complication of general infectious diseases (measles, scarlet fever, typhoid, pneumonia, influenza) or any purulent focus in the body and sepsis. In primary infectious myelitis, the infection spreads hematogenously, viremia precedes brain damage.

Pathogenesis (what happens?) during Acute myelitis:

In the pathogenesis of secondary infectious myelitis, autoimmune reactions and hematogenous infection in the spinal cord play a role. Intoxication myelitis is rare and may develop as a result of severe exogenous poisoning or endogenous intoxication. Traumatic myelitis occurs with open and closed injuries of the spine and spinal cord with the addition of a secondary infection. Cases of post-vaccination myelitis are not uncommon.

Pathomorphology. Macroscopically, the substance of the brain is flabby, edematous, swells; on the section, the pattern of the "butterfly" is smeared. Microscopically, hyperemia, edema, small hemorrhages are found in the focus area. infiltration with formed elements, cell death, myelin breakdown.

Acute myelitis symptoms:

The picture of myelitis develops acutely or subacutely against the background of general infectious symptoms: fever up to 38-39 ° C, chills, malaise. Neurological manifestations of myelitis begin with moderate pain and paresthesia in the lower extremities, back and chest, which are radicular in nature. Then, within 1-3 days, motor, sensory and pelvic disorders appear, grow and reach a maximum.

The nature of neurological symptoms is determined by the level of the pathological process. With myelitis of the lumbar part of the spinal cord, peripheral paraparesis, pelvic disorders in the form of true urinary and fecal incontinence are observed. With myelitis of the thoracic part of the spinal cord, there are spastic paralysis of the legs, pelvic disorders in the form of retention of urine and feces, turning into incontinence. With suddenly developing transverse myelitis, muscle tone, regardless of the location of the focus, may be low for some time due to diaschisis. When the spinal cord is damaged at the level of the cervical thickening, upper flaccid and lower spastic paraplegia develop. Myelitis in the upper cervical part of the spinal cord is characterized by spastic tetraplegia, damage to the phrenic nerve with respiratory distress, and sometimes bulbar disorders. Sensitivity disorders in the form of hypesthesia or anesthesia are conductive in nature, always with an upper limit corresponding to the level of the affected segment. Quickly, sometimes during the first days, bedsores develop on the sacrum, in the region of large skewers, femurs, and feet. In more rare cases, the inflammatory process covers only half of the spinal cord, which is manifested by the clinical picture of Brown-Sequard syndrome.

The forms of subacute necrotizing myelitis are described, which are characterized by damage to the lumbosacral part of the spinal cord, followed by the upward spread of the pathological process, the development of bulbar disorders and death. In the cerebrospinal fluid with myelitis, an increased protein content and pleocytosis are found. Cells may include polynuclear cells and lymphocytes. With liquorodynamic tests, protein is absent. In the blood, an increase in ESR and leukocytosis with a shift to the left are noted.

The course of myelitis acute, the process reaches its greatest severity after a few days, and then remains stable for several weeks. The recovery period lasts from several months to 1-2 years. Sensitivity is restored the fastest and the earliest, then the functions of the pelvic organs; movement disorders regress slowly. Often there are persistent paralysis or paresis of the limbs. The most severe course and prognosis are cervical myelitis due to tetraplegia, proximity of vital centers, and respiratory disorders. The prognosis is unfavorable for myelitis of the lower thoracic and lumbosacral localization due to severe damage, poor recovery of the functions of the pelvic organs and, therefore, the addition of a secondary infection.

Diagnosis of acute myelitis:

The acute onset of the disease with the rapid development of a transverse lesion of the spinal cord against the background of general infectious symptoms, the presence of inflammatory changes in the cerebrospinal fluid in the absence of a block makes the diagnosis quite clear. However, it is very important to promptly diagnose epiduritis, the clinical picture of which in most cases is indistinguishable from the symptoms of myelitis, but which requires urgent surgical intervention. In doubtful cases, exploratory laminectomy should be considered. When diagnosing epiduritis, one should keep in mind the presence of a purulent focus in the body, the appearance of radicular pain, and the syndrome of increasing compression of the spinal cord. Acute Guillain-Barré polyradiculoneuritis differs from myelitis in the absence of conduction disturbances of sensitivity, spastic phenomena and pelvic disorders. Spinal cord tumors are characterized by a slow course, the presence of protein-cell dissociation in the cerebrospinal fluid, and a block in liquorodynamic tests. Hematomyelia and hematorachia occur suddenly, are not accompanied by a rise in temperature; with hematomyelia, the gray matter is mainly affected; if the hemorrhage occurred under the membranes, then meningeal symptoms occur. History can often reveal indications of trauma.

Acute transverse lesion of the spinal cord must be differentiated from acute impairment of spinal circulation. Multiple sclerosis may be suspected, but is characterized by selective involvement of the white matter, often rapid and significant regression of symptoms after a few days or weeks, and evidence of diffuse involvement of the spinal cord and brain. Chronic meningomyelitis is characterized by slower development, lack of fever and is often caused by syphilitic lesions, which is established using serological tests.

Acute myelitis treatment:

In all cases, broad-spectrum antibiotics or sulfonamides should be given at the highest possible doses. Antipyretics are indicated to reduce pain and at high temperatures. Apply glucocorticoid hormones at a dose of 50-100 mg per day (or equivalent doses of dexamethasone or triamcinolone), ACTH at a dose of 40 IU twice a day for 2-3 weeks with a gradual dose reduction. Particular attention should be paid to preventing the development of bedsores and ascending urogenital infection. To prevent bedsores, which often occur over bony prominences, the patient must be laid on a circle, put cotton pads under the heels, wipe the body daily with camphor alcohol, and change position. When bedsores appear, necrotic tissues are excised and bandages are applied with penicillin or tetracycline ointment, Vishnevsky ointment. To prevent the formation of bedsores and after their appearance, ultraviolet irradiation of the buttocks, sacrum, and feet is carried out.

In the first period of the disease, urinary retention can sometimes be overcome by using anticholinesterase drugs; if this turns out to be insufficient, catheterization of the bladder with washing it with antiseptic solutions is necessary.

To prevent the development of contractures from the first day of the disease, passive exercise therapy should be carried out and the patient should be laid in bed, legs unbent at the hip and knee joints and bent at the ankle, for which rollers and special splints are used. After an acute period (2-4 weeks, depending on the severity of the disease), you need to move on to more active restorative measures: massage, passive and active exercise therapy, acupuncture, physiotherapy. Group B vitamins, prozerin, dibazol, galantamine, biostimulants, absorbable preparations are shown. With a sharp spasticity, seduxen, elenium, mellitin, baclofen, midokalm are used. In the future, sanatorium-resort treatment is recommended.

Employability. It is determined by the localization and prevalence of the process, the degree of impairment of motor and pelvic functions, sensory disorders. In the acute and subacute periods, patients are temporarily unable to work. With a good recovery of functions and the possibility of returning to work, the sick leave can be extended until practical recovery. With residual effects in the form of a slight lower paraparesis with weakness of the sphincters, patients are assigned III group of disability. With moderate lower paraparesis, impaired gait and statics, patients cannot work under normal working conditions and are recognized as group II disabled. If patients need constant outside care (paraplegia, tetraparesis, dysfunction of the pelvic organs), they are assigned a disability group I. If within 4 years the restoration of impaired functions does not occur, the disability group is established indefinitely.

Which doctors should you contact if you have Acute myelitis:

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Other diseases from the group Diseases of the nervous system:

Acute myelitis is very rare, but leads to serious consequences, up to disability. This disease can have different locations, as it covers several departments or the entire spinal cord. Transverse myelitis is much easier to treat than other types of the disease, but it greatly violates the integrity of the tissues of the spinal cord.

What is myelitis

The disease acute myelitis is characterized by what happens as a result of which the gray suffers at the same time and the person immediately feels the course of the inflammatory process, since the functioning of the spinal cord is disrupted.

The inflammatory process is very dangerous, as it leads to the fact that:

• movements are disturbed;
• there is numbness;
• paralysis of the limbs.

If timely treatment is not carried out, then the inflammatory process passes to the lower part of the brain.

Transverse myelitis

Acute transverse myelitis manifests itself in the form of pain in the neck, after which paresis, paresthesia, and dysfunction of the pelvic organs may gradually develop. Soreness grows rapidly, literally in a few hours or days. The severity of the course of the disease can also be different, so it is important to pay attention to the problem in a timely manner.

In very difficult cases, all reflexes initially disappear completely, and then hyperreflexia occurs. If permanent paralysis is observed, then this indicates the death of some. Often, this type of myelitis occurs against the background of influenza, measles, and many other infectious diseases. Vaccination can provoke the formation of an inflammatory process.

Often the disease manifests itself during the recovery period after the course of an infectious disease. This violation becomes the first sign of the onset of multiple sclerosis. In this case, it does not depend on vaccinations and infection.

Primary and repeated forms of damage

Primary forms of acute myelitis of the spinal cord are very rare and occur when exposed to:

• flu viruses;
• encephalitis;
• rabies.

The secondary form of the disease is considered a complication of syphilis, measles, sepsis, scarlet fever, pneumonia, tonsillitis. In addition, the disease can occur as a result of the presence of purulent foci. The causative agent of the disease enters the body through the lymph or brain tissue.

The disease can be observed in patients at different ages, but is most common in middle-aged patients. The inflammatory process is localized in the thoracic and lumbar regions. Along with general malaise, patients feel severe back pain. Symptoms of the disease largely depend on the severity of its course.

Myelitis classification

Classification of acute myelitis is carried out according to several criteria. This disease is divided into the following types:

• viral;
• traumatic;
• infectious;
• toxic;
• post-vaccination.

According to the mechanism of its development, the disease is divided into primary or secondary type. At the same time, it is worth noting that the secondary type of myelitis occurs against the background of many other diseases. According to the duration of the course, it is divided into:

• subacute;
• spicy;
• classical.

The inflammatory process is divided into several different types and prevalence. In this case, there are multifocal, diffuse and limited myelitis. Transverse myelitis refers to a limited type, as it is only a minor focus of the inflammatory process.

Causes

Acute myelitis in neurology is described as a disease that can be triggered by a variety of factors. It is divided into two main groups, formed according to the principle of the order of formation of the inflammatory process. The primary form of the disease occurs due to infection or injury to the spinal cord. The secondary form of the disease occurs against the background of the course of other diseases.

The infection can enter the circulatory system through an open wound. Viruses can enter the human body through the bites of insects, infected animals, and non-sterile medical equipment. Secondary foci of the infectious process are formed in the spinal cord when affected by such pathogens:

• exposure;
• electrical injury;
• decompression sickness.

In neurology, acute myelitis can also occur due to a violation of metabolic processes, which include the following:

• diabetes;
• anemia;
• chronic liver disease.

In addition to all these reasons, the inflammatory process can be triggered by the penetration of various toxic substances, heavy metals into the body. Inflammation can also be triggered by vaccination against one of the viral diseases.

Development mechanisms

Acute myelitis can occur as a result of infection entering the body through the blood or spinal nerves. Initially, the space passing between the membranes is infected, and then only the main brain tissues are involved in the pathological process.

The spinal cord is divided into separate segments, each of which corresponds in size to the vertebrae. Each of them is responsible for reflexes and transmits certain signals to the brain from internal organs and muscle groups. Depending on the number of affected segments, myelitis can be limited, distributed over all parts of the spinal cord, or localized in adjacent and unrelated areas.

Symptoms of the disease

Initially, during the course of acute myelitis, symptoms appear that are characteristic of absolutely any inflammatory process in the body. This disease is characterized by a sharp increase in temperature. At the same time, there may be aching bones, a feeling of general malaise, chills, and fatigue. In this regard, many people mistake this disease for a simple cold.

Neurological disorders appear much later, when the lesion manifests itself in the form of pain in the affected area. Discomfort in this case extends not only to the back area, but also to the limbs, giving it to the internal organs. Symptoms largely depend on the area of ​​localization of the inflammatory process. Loss of sensation, as well as shuffling of the legs, is observed with the defeat of the lumbar region. However, there is a lack of reflexes and impaired functioning of the pelvic organs.

With the localization of the inflammatory process in the cervical region, the main sign of the lesion will be difficulty breathing, pain when swallowing, as well as impaired speech. In addition, there is a general malaise, weakness and dizziness. Thoracic myelitis is expressed in stiffness of movements and the presence of pathological reflexes. In this case, there may be violations of the functioning of some organs.

If signs of the disease are found, it is imperative to consult a doctor for the diagnosis and treatment of acute myelitis, since over time the situation can only worsen significantly. This threatens with disability and deprivation of the ability to move normally.

Carrying out diagnostics

The diagnosis of acute myelitis can only be made after a comprehensive examination. Initially, the doctor collects an anamnesis, and also examines the patient. To assess the severity of the course of the disease, the doctor prescribes a neurological examination, which includes:

• sensitivity assessment with determination of the area of ​​violation;
• determination of muscle tone of the affected limbs;
• checking reflexes;
• definition of violations from the internal organs.

Diagnosis of acute myelitis is also carried out using laboratory research methods that will help to establish the main cause of the inflammatory process. These methods include:

• general and biochemical blood test;
• blood serology.

Instrumental techniques allow you to determine the localization and extent of the pathological process. A consultation with a neurosurgeon may be required to make a definitive diagnosis.

Complex treatment

The treatment of acute myelitis largely depends on how severely the spinal cord is affected, and which particular segment of it is affected by the inflammatory process. Often the patient requires urgent surgical intervention. The operation makes it possible to eliminate pressure on the vertebrae and spinal canal, which can provoke the occurrence of pain.

To eliminate fever and inflammation, antipyretic drugs and antibiotics are prescribed. In the course of therapy carried out with bedridden patients, it is necessary to include measures to combat bedsores, namely, the treatment of the skin with camphor oil, the insertion of rubber rings and the frequent change of bed linen. If the functioning of the internal organs is disturbed, anticholinesterase drugs are initially prescribed for urine output, and then catheterization and antiseptic solutions are required.

To return the patient the ability to move normally, the doctor prescribes "Prozerin", "Diabazol" and vitamin B. Taking medications should be combined with therapeutic exercises and massage.

What are the possible complications

Acute myelitis can lead to the fact that the patient remains bedridden for life. In some cases, when running, it can lead to the death of the patient. If the pathological process has spread to the neck, and paralysis of the abdominal and thoracic nerves is also observed, then this can lead to problems with the respiratory system. A purulent lesion can provoke sepsis, which ultimately leads to tissue death.

Preventive measures

Prevention implies timely vaccination against infectious diseases that provoke the occurrence of an inflammatory process in the region of the brain and spinal cord.

Poliomyelitis can cause a violation of the motor function of the cervical spine. Parotitis affects the salivary glands. Measles is characterized by coughing and rashes on the skin and oral mucosa. In order to prevent infection, you need to be very careful about your health and if any signs of malaise occur, immediately consult a doctor for treatment.

Course and forecast

The course of the disease is very acute and the pathological process reaches its greatest severity just a few days after infection, and then stability is observed for several weeks. The recovery period can be from several months to 1-2 years. First of all, sensitivity is restored, and then the functions of internal organs. Motor functions are restored very slowly.

Often, for a long time, the patient has sustained paralysis of the limbs or paresis. Cervical myelitis is considered the most severe in its course, since the inflammatory process occurs in close proximity to the vital centers and respiratory organs.

An unfavorable prognosis is also observed in myelitis of the lumbar region, since as a result of the course of an acute form of the disease, the functions of the pelvic organs are restored very slowly, and as a result, a secondary infection may join. The prognosis worsens in the presence of concomitant diseases, in particular, such as pneumonia, pyelonephritis, as well as frequent and severe bedsores.

Patient's ability to work

The patient's ability to work is largely determined by the prevalence and localization of the pathological process, the degree of sensory disorders and impaired motor functions. With the normal restoration of all the required functions, the patient can return to his usual work after a while.

With residual effects in the form of lower paresis, as well as weakness of the sphincters, patients are assigned a 3rd disability group. With a clear violation of gait, the patient is given a 2nd group of disability. And if a person needs constant outside care, then he is assigned 1 disability group.

12.07.2016

A number of causes can lead to (myelitis) inflammation of the spinal cord, each of them causes myelitis to develop according to a strictly defined dangerous scenario. To prevent a sad result, it is possible to seek help from a doctor immediately, as soon as the body has given a signal for help, called the symptoms of the disease.

Signs of illness

For the development of myelitis, a preliminary defeat of the body by infection, intoxication, or the presence of injury is necessary.

Inflammation of the spinal cord caused by infection is usually preceded by polio, rabies, syphilis, or tuberculosis. Complications of influenza, measles, pneumonia, typhoid or scarlet fever can also play a role.

Cases of intoxication myelitis are recorded quite rarely. Injuries to the spine lead to myelitis as a result of the addition of a secondary infection with ineffective treatment of the original problem or no treatment.

A disease of the spinal cord for some time disguises itself under the mask of another lesion of the body, which makes a person not worry too much about the rise in body temperature and general weakness. The patient is sure that he knows exactly the cause of the symptoms that have arisen, and is actively struggling with it. The neurological side of the disease manifests itself somewhat later.

The main symptom of myelitis is the appearance chest pain, lower limbs and back. The intensity of the pain is more likely to cause inconvenience to a person than to immediately turn to a specialist.

Some patients (especially in cases of myelitis as a result of tuberculous lesions) believe that a new symptom is the result of insufficiently effective treatment of the disease that struck the body first.

Awareness of the unnatural behavior of the disease occurs with the appearance of disorders of motor function, loss of sensitivity and malfunctions of the pelvic organs. They appear mildly, but quickly increase, reaching their maximum. For this process, only three days of inactivity is enough.

Symptoms of myelitis may vary slightly in different cases. It all depends on the part of the spine where the inflammation began:

• Inflammation of the lumbar spinal cord is characterized by the absence of reflexes of the lower extremities, their numbness, loss of sensation, and even paresis. There are also deviations in the work of the pelvic organs.
• With inflammation of the cervical region, pain occurs when swallowing, dizziness, malaise, difficulty breathing and trying to speak.
• Myelitis of the thoracic region hinders movement, provokes malfunctions in the work of the internal organs of the peritoneum. Pathological reflexes appear.

Symptoms of chronic myelitis of the spinal cord are not so pronounced due to the slow development of the disease. Its basis is considered to be a syphilitic lesion, therefore, the initial sign of the disease in the form of a high temperature is not observed. It is possible to determine the presence of myelitis using the results of laboratory tests.

Treatment

Myelitis requires immediate treatment. Every day of delay can lead to loss of motor function. Do not allow to wait and pain, quickly gaining intensity.

When an acute form of myelitis is taken, doctors prescribe an urgent surgical intervention, the purpose of which is to remove the compression of the vertebrae, which provokes inflammation of the spinal canal.

Regardless of whether surgery was performed or not, the course of treatment includes funds for:

Treatment of a person with impaired motor function as a result of the development of myelitis is accompanied by special care.

Important! Why does my back hurt. With inflammation of the spine, there is a high risk of rapid development bedsores, which requires a regular change of bed linen, hygienic treatment of the skin of a lying patient, rubbing it with camphor oil, and ultraviolet irradiation. For a bedridden patient, due to poor ventilation of the lungs, stale air and ordinary dust become dangerous, so it is necessary to ensure regular ventilation of the room and wet cleaning.

To restore the motor function of the spinal cord affected by myelitis, doctors may prescribe passive gymnastics in combination with vitamin B and prozerin or dibazol. The inability to move quickly leads to disturbances in the functioning of the pelvic organs, problems with urination appear.

At the first stage, it is possible to cope with the problem by taking anticholinesterase drugs, but if they are ineffective, one has to turn to the catheterization procedure. It must be accompanied by washing with antiseptic agents of the bladder in order to avoid the development of cystitis or other diseases of this group.

Myelitis develops quickly, causing serious damage to the body. With this disease, there is no time to experiment with traditional medicine methods or cheap analogues of drugs prescribed by a doctor. To prevent the onset of disability or even death, the patient must immediately seek medical help and begin treatment.

Signs, treatment of myelitis of the spinal cord updated: April 9, 2019 by: vitenega

Stroke Probability Calculator

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Stroke is a rather dangerous disease, which affects people far from only old age, but also middle and even very young people.

A stroke is an emergency situation that requires immediate help. It often ends in disability, in many cases even death. In addition to blockage of a blood vessel in the ischemic type, a cerebral hemorrhage against the background of high blood pressure, in other words, a hemorrhagic stroke, can also cause an attack.

Risk factors

A number of factors increase the chance of having a stroke. For example, genes or age are not always to blame, although after 60 years the threat increases significantly. However, everyone can do something to prevent it.

1. Avoid hypertension

High blood pressure is a major risk factor for stroke. Insidious hypertension does not show symptoms at the initial stage. Therefore, patients notice it late. It is important to have your blood pressure checked regularly and take medications for elevated levels.

2. Quit smoking

Nicotine constricts blood vessels and raises blood pressure. A smoker is twice as likely to have a stroke than a non-smoker. However, there is good news: those who quit smoking significantly reduce this risk.

3. With excess body weight: lose weight

Obesity is an important factor in the development of cerebral infarction. Obese people should think about a weight loss program: eat less and better, add physical activity. Older people should talk to their doctor about the extent to which they benefit from weight loss.

4. Keep cholesterol levels normal

Elevated levels of "bad" LDL cholesterol lead to deposits in the vessels of plaques and embolism. What should be the values? Everyone should find out individually with a doctor. Since the limits depend, for example, on the presence of concomitant diseases. In addition, high values ​​of "good" HDL cholesterol are considered positive. A healthy lifestyle, especially a balanced diet and plenty of exercise, can positively affect cholesterol levels.

5. Eat healthy food

Useful for blood vessels is a diet that is commonly known as "Mediterranean". That is: lots of fruits and vegetables, nuts, olive oil instead of cooking oil, less sausage and meat, and lots of fish. Good news for foodies: you can afford to deviate from the rules for one day. It is important to eat right in general.

6. Moderate alcohol consumption

Excessive alcohol consumption increases the death of stroke-affected brain cells, which is unacceptable. Complete abstinence is not required. A glass of red wine a day is even helpful.

7. Move actively

Movement is sometimes the best thing you can do for your health in order to lose weight, normalize blood pressure and maintain the elasticity of blood vessels. Ideal for this endurance exercise, such as swimming or brisk walking. Duration and intensity depend on personal physical fitness. Important Note: Untrained people over 35 years of age should be initially examined by a doctor before starting to exercise.

8. Listen to the rhythm of the heart

A number of heart conditions contribute to the likelihood of a stroke. These include atrial fibrillation, birth defects, and other rhythm disturbances. Possible early signs of heart problems should not be ignored under any circumstances.

9. Control your blood sugar

People with diabetes are twice as likely to have a cerebral infarction than the rest of the population. The reason is that elevated glucose levels can damage blood vessels and promote plaque buildup. In addition, diabetic patients often have other risk factors for stroke, such as hypertension or too high blood lipids. Therefore, diabetic patients should take care of the regulation of sugar levels.

10. Avoid stress

Sometimes stress has nothing wrong, it can even motivate. However, prolonged stress can increase blood pressure and susceptibility to disease. It can indirectly cause a stroke. There is no panacea for chronic stress. Think about what is best for your psyche: sports, an interesting hobby, or perhaps relaxation exercises.