acute transverse myelitis, an inflammation of the entire thickness of the spinal cord, affecting both the sensory and motor nerves. It can develop rapidly and is accompanied by necrosis and neurological deficit that commonly persist after recovery. Patients in whom spastic reflexes develop soon after the onset of this disease are more likely to recover. This disorder may result from a variety of causes, such as multiple sclerosis, measles, pneumonia, viral infections, and the ingestion of certain toxic agents such as carbon monoxide, lead, and arsenic. Such poisonous substances can destroy the entire circumference of the spinal cord, including the myelin sheaths, axons, and neurons, and can cause hemorrhage and necrosis. ▪ INTERVENTIONS: Initial medical treatments are designed to reduce spinal cord inflammation and to manage and alleviate symptoms. Antiinflammatory corticosteroid therapy is prescribed soon after the diagnosis is made to decrease inflammation and to improve the chance for and speed of neurological recovery. Many forms of long-term rehabilitative therapy are available for people who have permanent disabilities resulting from transverse myelitis. ▪ PATIENT CARE CONSIDERATIONS: There is no cure, and the prognosis for complete recovery is poor. Immediate patient care includes frequent assessment of vital signs, vigilance for signs of spinal shock, maintenance of a urinary catheter, and proper skin care. Strategies for carrying out activities in new ways to overcome, circumvent, or compensate for permanent disabilities are essential. Functional independence is possible with appropriate therapies and facilitates the attainment of the best possible quality of life.
