Can older women have both MS and transverse myelitis?

Question

Hi doctor,

My grandmother has been diagnosed with multiple sclerosis (MS) and transverse myelitis, and she’s currently taking medication for both. She’s feeling confused and concerned about how these two conditions are connected and whether having both makes things more complicated. Lately, she’s been experiencing symptoms like persistent back pain, numbness, and difficulty walking. She’s not sure if these are signs of a relapse or simply side effects of her medications.

We're trying to understand what might be causing these issues. How can we figure out whether her symptoms are due to a flare-up or her treatment? Are there any tests she should undergo or changes to her medications that might help? She’s also worried about the long-term impact on her spinal cord and nervous system. Should she be doing anything specific, such as physical therapy or making lifestyle changes, to help protect her function and prevent further damage?

Lastly, are there any new treatments or clinical trials for MS and transverse myelitis that might be worth exploring? We would really appreciate guidance on how to best support her and manage her condition moving forward.

Please help me.

Thanks.

Answer 1

Hi,

Welcome to icliniq.com.

I can understand your concern.

Your grandmother’s diagnosis of both multiple sclerosis (MS) and transverse myelitis (TM) can certainly make things feel more complicated. However, if we’re able to clearly differentiate between the two conditions, managing her treatment and symptoms becomes much more straightforward. Let me break it down to help you understand better.

MS is a chronic autoimmune disease that attacks the myelin sheath (covering of the nerve) in the central nervous system (CNS), leading to recurring episodes of neurological symptoms.

Transverse myelitis (TM) is a neurological condition that causes inflammation across both sides of a section of the spinal cord. This can lead to the sudden onset of symptoms such as weakness, numbness, and pain. TM may sometimes be an early sign of multiple sclerosis (MS), or it can occur on its own. MS can also cause spinal cord inflammation, and the symptoms may look similar to TM, but there are differences. MS tends to cause recurrent episodes, while TM is often a single event or progresses gradually over time.

Your grandmother’s current symptoms could be due to either a relapse or side effects from her medication. A contrast MRI of the brain and spinal cord can help check for active inflammation, new MS lesions, or worsening of TM-related damage. If the MRI looks unchanged and her symptoms started after a change in medication, side effects might be the cause. Her neurologist can review her treatment and possibly adjust the dosage or switch medications. Persistent symptoms like pain or numbness can result from nerve damage, even after the inflammation subsides. Medications like Gabapentin or Pregabalin may help manage this.

Helpful test to consider:

MRI with contrast.
Lumbar puncture.
Complete blood work (to rule out vitamin deficiencies or infections).
Nerve conduction studies (NCS) and electromyography (EMG).

Lifestyle and supportive care:

Physical therapy is essential, gentle exercises like yoga, stretching, or swimming can improve strength and mobility.
Mobility aids such as a cane or walker may help reduce fall risk.
Bladder issues should be evaluated by a urologist.
Heat therapy or gentle massage can ease chronic pain, but always check with her doctor first.

Above all, it’s important she keeps her neurologist informed about any new symptoms or therapies. Working closely with her care team will help her manage her condition more effectively.

Feel free to follow up with any further questions or concerns.

I hope this information helps you.

Thank you.