Infectious myelopathy
Infectious myelopathy is a viral disease that affects the spinal cord and provokes such pathological conditions as loss of sensitivity, numbness, paralysis. These symptoms cause dysfunction of the musculoskeletal system and malfunctions of the pelvic organs. Mainly this is impaired urination, there are other signs. This disease is neurological, its full clinical picture directly depends on how much the spine is affected.
The content of the article:
Symptoms of infectious myelopathy
Diagnosis of infectious myelopathy
Treatment of infectious myelopathy
Prevention and prognosis of infectious myelopathy
Infectious myelopathy
To date, the main cause of the occurrence and development of infectious myelopathy is herpes zoster, which gives on sciatica.
Symptoms of infectious myelopathy
In viral myelopathy, the pathological process is observed simultaneously in the gray and white matter of the spinal cord with the presence of lymphocytes in the CSF. Systemic infections of bacterial and mycobacterial etiology can provoke intramedullary abscesses of spinal cord tissues.
Chronic pathological processes in the membranes of the spinal cord are described, which in syphilis cause slowly developing subpial myelitis and sciatica. Manson’s intestinal schistosomiasis causes pronounced inflammatory, necrotic and granulomatous myelitis. This relationship is due to the reaction to special enzymes that break down tissues. These enzymes are produced by the eggs of the parasite that provokes the disease.
As with any inflammatory process that has an infectious character, this type of myelopathy is characterized by a high body temperature. Redness and soreness occur in the affected areas, sensitivity is disturbed when touching and pressing. Depending on the place where the infection is localized, weakness of the limbs and paralysis of individual parts of the body may occur. The work of internal organs is disrupted, which leads to problems with urination and improper operation of the musculoskeletal system.
The described symptoms are accompanied by a general malaise, a feeling of constant fatigue, which at the beginning of the disease, combined with an elevated temperature, makes it possible to confuse this disease with acute respiratory infections, flu or any other cold.
Diagnosis of infectious myelopathy
The process of diagnosing myelopathy is aimed not only at identifying it, but also at excluding other pathologies, including diseases with similar symptoms and disorders of the central nervous system. Also, the purpose of the diagnosis is to establish the etiology of the disease.
To make a diagnosis, it is necessary to conduct a study that will make it possible to study the spinal cord and brain of the patient. The spine is examined using CT and MRI, the data of which give a complete picture of all possible tumors and other neoplasms, as well as the position of the intervertebral discs.
For more detailed visualization of the vertebral bones, the doctor can refer the patient to a computer X-ray tomography of the vertebral column and a detailed examination of the circulatory system. Electromyography helps to assess the degree of passage of electrical excitation through the spinal cord and peripheral nerves, which is necessary to obtain a complete picture of the course of the disease.
In addition, a blood test is necessary to diagnose an infectious infection, obtain data on viscosity, and identify autoimmune or metabolic diseases of the spinal cord. The list of tests that diagnose myelopathy and find out the cause of its development includes a general blood test, a biochemistry test, blood and liquor culture for sterility.
Depending on the symptoms indicated by the patient, electroneurography, evoked potentials, lumbar puncture, MR or CT angiography of the spinal cord are performed at the discretion of the doctor. If for some reason there is no possibility of MRI, myelography and discography are performed.
For the most accurate diagnosis of the disease, a neurologist can involve other specialists in the examination of the patient: an oncologist, a venereologist, a vertebrologist, a phthisiologist. Suspecting demyelinating hereditary myelopathy, a neurologist is working on a diagnosis together with a geneticist.
Treatment of infectious myelopathy
The infectious nature of myelopathy requires a comprehensive approach to the treatment process. At the same time, the patient’s recovery lasts longer than in cases when the spine is affected by other varieties of this disease. Treatment in this case is aimed at destroying the infection, carried out with the help of strong antibiotics.
To improve the general condition of the patient and stabilize body temperature, the doctor prescribes antiviral and antipyretic drugs and medications that eliminate inflammatory formations. The duration of the course of treatment, as well as the methods, is determined exclusively by the attending physician and depends on the degree of development of myelopathy and the characteristics of the patient’s body.
In the treatment of any myelopathy, it is necessary to influence the spinal cord in such a way that the metabolic processes in its tissues normalized, and their susceptibility to hypoxia decreased to a minimum. To do this, patients are prescribed neuroprotective drugs and metabolites: actovegin, cerebrolysin, piracetam. Vitamins B1 and B6 are required.
Physiotherapy plays an important role in the treatment of this disease. Its purpose is to slow down the process of myelopathy development and cupping. For most patients, the selection of optimal methods of physiotherapy is carried out individually. These are mainly UHF, paraffin therapy, galvanization, diathermy, electrophoresis and other techniques.
For many patients with myelopathy, doctors prescribe courses of therapeutic and recreational physical education in order to compensate for the lack of motor activity, increase self-service capabilities and prevent serious complications such as muscular atrophy, joint contracture, bedsores and congestive pneumonia. Along with physical therapy, treatment of myelopathy includes massage.
If, as a result of the progression of the disease, the spinal cord is compressed, surgical intervention is indicated.
Prevention and prognosis of infectious myelopathy
Myelopathy involves an ambiguous prognosis of the patient’s condition at the end of treatment. Crucial in this is how much the pathology affected the nerve fibers and whether the spinal cord was affected. If he was not affected or the treatment was carried out competently and promptly, a full recovery can be predicted. The infectious type of this disease can be completely cured, provided that a timely course of therapy is carried out aimed at eliminating the infection that was the cause of its development.
A chronic disease, such as arthritis or osteoporosis, can aggravate the patient’s condition and prevent recovery, but temporary improvement and the absence of progression of pathology is achievable.
In the case when, despite enhanced treatment, the disease continues to develop, the patient is assigned a disability group due to disability. The condition of disability can be triggered by a violation of the transmission of nerve impulses in parts of the body, which in turn causes a restriction of limb mobility.
After surgery, the prognosis depends on how deep the lesion of the pathology of nerve tissues was. For example, after the removal of a hernia, which was the cause of myelopathy, patients recover, but subject to small changes due to tissue compression.
Due to this disease, there is a high probability of dependence on analgesics. A reduced level of conduction of nerve impulses in the extremities is another possible consequence.
Prevention of infectious myelopathy directly depends on the fight against viral diseases. It implies measures to prevent them, as well as to strengthen immunity in order to increase the level of resistance of the body.
