Myelitis is inflammation of the spinal cord which can disrupt the normal responses from the brain to the rest of the body, and from the rest of the body to the brain. Inflammation in the spinal cord, can cause the myelin and axon to be damaged resulting in symptoms such as paralysis and sensory loss. Myelitis is classified to several categories depending on the area or the cause of the lesion; however, any inflammatory attack on the spinal cord is often referred to as transverse myelitis. Types of myelitis
Myelitis lesions usually occur in a narrow region but can be spread and affect many areas. Acute flaccid myelitis: a polio-like syndrome that causes muscle weakness and paralysis. Poliomyelitis: disease caused by viral infection in the gray matter with symptoms of muscle paralysis or weakness
Transverse myelitis: caused by axonal demyelination encompassing both sides of the spinal cord
Leukomyelitis: lesions in the white matter
Meningococcal myelitis (or meningomyelitis): lesions occurring in the region of meninges and the spinal cordOsteomyelitis of the vertebral bone surrounding the spinal cord (that is, vertebral osteomyelitis) is a separate condition, although some infections (for example, Staphylococcus aureus infection) can occasionally cause both at once. The similarity of the words reflects that the combining form myel(o)- has multiple (homonymous) senses referring to bone marrow or the spinal cord. Symptoms
Depending on the cause of the disease, such clinical conditions manifest different speed in progression of symptoms in a matter of hours to days.
If necessary, genetic testing for PHEX (phosphate regulating gene with homologies to endopeptidase on the X-chromosome) can be used to conclusively diagnose XHR and testing for the FGF23 gene will identify patients with ADHR. Treatment
Resection of the tumor is the ideal treatment and results in correction of hypophosphatemia (and low calcitriol levels) within hours of resection. Resolution of skeletal abnormalities may take many months. If the tumor cannot be located, begin treatment with calcitriol (1–3 µg/day) and phosphate supplementation (1–4 g/day in divided doses). Tumors that express somatostatin receptors may respond to treatment with octreotide. If hypophosphatemia persists despite calcitriol and phosphate supplementation, administration of cinacalcet has been shown to be useful. References
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