Acute Transverse Myelitis Symptoms and Causes in Children

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In-Depth

What causes Acute Transverse Myelitis (ATM)?

ATM is an "autoimmune" condition that often follows an infection, such as a cold. The immune system protects the body from invaders, like bacteria and viruses.

Autoimmune diseases confuse your child's immune system. Instead of fighting against bacteria or viruses, it attacks healthy cells and tissue.

If your child has ATM, her immune system reacts against her spinal cord. Autoimmunity is not contagious, but may be genetic (inherited from parents).

ATM may also happen after a child is vaccinated, although this is rare. In some cases of ATM, a specific trigger/cause cannot be identified.

What are the symptoms of ATM?

The symptoms of ATM come on quickly and can include:

  • pain
  • weakness
  • numbness or tingling
  • loss of bowel and bladder function

Weakness and numbness occur on both sides of the body, which is why it is called "transverse."

If the thoracic portion (middle) of your child's spinal cord is affected, her legs will be affected, but her arms won't.

If the cervical portion (upper) of your child's spinal cord is affected, both her arms and legs can be affected. In severe cases, breathing can be affected.

What is the prognosis of ATM?

Steroid treatment can reduce some symptoms and stop new symptoms from developing.

Although the long-term prognosis for children with ATM varies, most children make a complete or nearly complete recovery, including those children with initially severe symptoms.

For most children, recovery begins within days and continues for up to one year. Motor function usually improves faster than bowel and bladder function.

Some patients can have residual symptoms such as weakness, numbness or urinary problems.

Will ATM affect my child's school performance?

Because ATM doesn't affect the brain, most children perform as well as they ever did at school. However, some children do fall behind in their school work. This could be the result of missed school days during the illness.

If you notice changes in your child's school performance, it is important to let your doctors and nurses know so that we can work with the school to develop an educational plan.

Will my child get ATM every time she has an infection?

No. In more than 90 percent of patients, ATM occurs only once. In some patients, it can re-occur. It is not known why patients develop ATM with certain infections at certain times.

If you notice symptoms during an infection that you think are unusual, such as weakness, numbness or imbalance, it is important to notify your child's doctor immediately.

How is ATM similar to multiple sclerosis (MS)?

  • Both ATM and MS involve autoimmune responses to myelin in the spinal cord. They are both "demyelinating" disorders.
  • Symptoms common to both disorders include weakness, numbness and bowel and bladder problems.
  • Corticosteroids are used to treat attacks of ATM and MS.

How is ATM different from MS?

  • ATM typically occurs only once, while patients with MS have further, repeated attacks of inflammation in the brain and spinal cord.
  • Most patients with MS are treated with ongoing medication to prevent such attacks. Patients with ATM don't require such medication.

Can a child with ATM ever develop MS in the future?

Although it is uncommon, children who initially have ATM can later develop MS. Children who have the "complete" form of ATM with more severe symptoms actually appear to be at lower risk of developing MS than patients with "partial" ATM.

Regardless of which form of ATM your child has, it is important for her to have ongoing follow-up care. Let the doctor know immediately if your child develops new symptoms, such as:

  • visual loss
  • weakness
  • numbness
  • loss of balance
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