Questions for Dr. Wise

[alissa]

My husband, a 36 yr. old, able-bodied, gulf war veteran became seriously ill with what we thought was a flu in mid- March.
It started out as a pretty bad upper resperatory infection that seemed to clear up in about a week. He started having low grade fevers, severe sweating with the slightest bit of activity, inability to void (emptied 2 liters when foley was inserted) and sensory dysfunction from the chest down and severe muscle weakness with some spasticity. MRI and blood tests came back negative - thorasic spinal tap
showed swelling and protein count of 38 (?).

He was diagnosed with transverse myelitis (I think encephalomyelitis was thrown around, too).

He was admitted March 31 and given IV solumedrol for 3 days, released with 3 day step-down dose of prednisone. He recovered fast, and was voiding, walking, some sensory return at time of release.

He is now almost normal, with just the slightest bit of sensory dys. in small areas in his legs. Full return in activity levels.

My questions are, what could this possibly mean in the future? I've been reading that this could be related to chronic conditions such as ME/FM. HE WAS TESTED FOR ms (NEGATIVE).

Since he is a gulf war vet, we worry about possible related illnesses (ME and mycoplasma are mentioned). Do you have any thoughts about testing he should be undergoing to find any underlying sources/illnesses?

Thank you for any suggestions, resources, etc. you might have.

Peace,
Alissa

[Wise Young]

Alissa, I had answered your question on a private topic but found this in the Feedback Forum and so thought that I would make my answer to your question public:

Alissa, sorry about not responding to your message for the past several days. I am so glad that your husband recovered from his episode of TM. The use of solumedrol (methylprednisolone) hopefully contributed that recovery. If I were he, I would:
1. be vigilant for further episodes and be ready to treat it rapidly with methylprednisolone and as early as possible after symptom onset. I suspect that one of the reasons why methylprednisolone treatment does not always work is because it is being started too late. In spinal cord injury, the treatment must be given within 8 hours and preferably within an hour.
2. take aspirin as an anticoagulant. This is because there is some data suggesting that TM may be associated with ischemia to the spinal cord (a relatively high percentage of TM probably have vasculitis (inflammation of blood vessels) and this may be partly responsible for loss of blood flow and the onset of TM. The dosing of aspirin should be the same as that used to prevent heart attacks and stroke.
3. avoid getting vaccines for flus and other conditions since some 50% of TM cases are associated with some kind of viral exposure or vaccine.
4. hope that it does not recur.

Wise.