Spinal inflammation–the mysterious scourge

It happened quite suddenly. Bea Ledesma, group publisher of Hinge Inquirer Publications, stood up from a low chair and fell to the floor. Her knees, without warning, became so weak that they could not hold her body upright.

At first, she tried to rationalize that maybe her knees gave way because she had been bedridden for a week. Ledesma at that time had been confined at a hospital for persistent numbing and tingling sensation on her lower extremities. Although there was no definite finding about her condition that brought her to the hospital, she said it could be due to her diabetes.

“I thought I just needed to walk,” she said. “So I walked around the room, pushing my IV stand when it ran over my foot and I didn’t feel it. Then I fell again.” It was then that she realized the gravity of her illness.

The abrupt weakening of the knees, and the thought of becoming crippled for life, terrified her. “I’ll kill myself. I don’t want to be a cripple,” she told her mom.

Her doctors, all seven of them, have different theories, she said. They ran tests on her—spinal MRI, nerve and muscle tests, MRI of the brain—all of which came back normal.

Then her neurologist, Dr. Nanette Domingo-Reyes, told her that she could be among the 10 percent that registers negative but might actually have something wrong.

As a last resort, her doctors performed a spinal tap. “All came back normal except for one level that was quite high,” Ledesma recalled.

New tests for autoimmune diseases were performed, but again results turned out negative.

The numbness in her legs and the weakness, Ledesma said, are two different issues but both originate in the spine.

Her doctors now think she may have spinal inflammation, or transverse myelitis, that could have been caused by anything—from autoimmune disease to a viral infection, she said.

Respiratory virus

“Transverse myelitis is caused by a respiratory virus and is more common in people with weak immune system, like diabetics, the elderly, those with autoimmune diseases or HIV,” Reyes explained.

Transverse myelitis is an inflammation of the spinal cord. It could also be a result of an injury across the spinal cord, affecting sensation when transmission of the nerve signals are disrupted.

Symptoms may include abnormal sensations like tingling, coldness, numbness; weakness in the arms or legs—some patients report legs feeling heavy or dragging of one foot; or pain in the neck or back; bladder dysfunction and/or bowel motility problems.

The exact reason for transverse myelitis is not yet known. About 40 percent of the cases are linked to viral infection of the respiratory tract; and to a virus that affects the spinal cord as well, including zoster, the same virus responsible for chicken pox and shingles. The rest of the cases are of unknown cause.

Other factors linked to transverse myelitis include autoimmune diseases such as lupus and Sjogren’s syndrome, multiple sclerosis and even vaccinations for infectious diseases such as diphtheria-tetanus, hepatitis B and measles-mumps-rubella.

“My doctors asked me if I had a cough the week before because that may have caused it,” Ledesma said.

She used to walk around with a cane. Today, she said she tries to walk longer distances whenever she can sans the cane as she didn’t want to become too dependent on it.

Once, she said, she fell while crossing the street toward Crate and Barrel in SM Makati. Two guards came to her rescue but her knees and elbows were already bleeding.

“I fell on the street,” she told the salesperson.

“I know,” the salesperson said, “we all saw it happen from the window.” The staff applied alcohol on her wounds and Ledesma went on shopping.

“I didn’t want it to be the  focus… If you think like ‘you’re sick, you’re sick,’ your body responds to it. I mean, I’m not 100 percent better but I’m not going to let that stop me from doing what I want to do,” she said.

It helps that she has a strong personality. When she was diagnosed with Type II diabetes, for example, she changed her diet, even went on a raw veggie diet and dropped more than 50 pounds over time. She has managed to reverse her condition and is now diabetes-free.

“You don’t realize how much you take your health for granted until something happens to you,” Ledesma said.

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