Causes | Inflammation of the spinal cord

Causes

The causes for the occurrence of a spinal cord inflammation can be quite different. Most often, the inflammation is due to a specific infection. For example, infections with some viruses, but also bacteria, can be the cause of such an inflammation.

Some examples of viral pathogens that can cause the occurrence of a spinal cord inflammation are Hepatitis C, HIV, herpes simplex or influenza. Inflammation of the spinal cord can also occur after certain vaccinations (for example, smallpox vaccination). Bacteria can also cause inflammation if the spinal cord is infected.

It is also thought that certain autoimmune diseases may be responsible for the occurrence of spinal cord inflammation. The reason for this is that instead of defending against pathogens, the body’s autoimmune cells direct themselves against the body’s own cells and cause inflammation there. Autoimmune diseases such as sarcoidosis, systemic lupus erythematosus (SLE), the so-called Sjögren’s symptom or multiple sclerosis (MS) can be responsible for the occurrence of spinal cord inflammation.

In multiple sclerosis, it is also discussed that the occurrence of disseminated spinal cord inflammation may be a first manifestation, i.e. the first sign of an emerging MS. The occurrence of idiopathic inflammation of the spinal cord, which causes the above-mentioned symptoms for no apparent reason, is also possible.Idiopathic means that no apparent reason can be established why such inflammation occurs. This is the case if no cause is diagnostically found which would seem plausible as an explanation for the inflammation.

Overall, it must be mentioned that the cause of most spinal cord inflammation remains unexplained even after the symptoms have subsided. Vaccinations are one of the greatest achievements of modern medicine and have already saved countless lives, so it is advisable to have the protective vaccinations recommended by the STIKO (permanent vaccination commission) carried out! After a vaccination, the so-called vaccination reaction can occur with symptoms such as aching limbs and slight fever, which disappear again after a short time.

This is harmless and even a good sign, as it indicates the reaction of the immune system to the vaccine. In extremely rare cases, some vaccinations can sometimes trigger serious illnesses, an example of this is acute demyelinating encephalomyelitis, or ADEM for short. It is not yet clear how and whether ADEM is related to vaccinations, but it occurred occasionally after vaccinations, but much more frequently after infections.

ADEM is an autoimmune disease in which the myelin sheaths of the nerve cells of the brain and spinal cord are attacked and destroyed, which can lead to severe neurological damage. ADEM is often compared to MS, but unlike MS, ADEM always occurs in one attack. The prognosis is generally good, in most cases the symptoms recede completely, but in rare cases permanent impairment may occur.

Inflammation of the spinal cord is usually only rarely caused by bacteria. It is not conclusively clear whether the bacteria themselves cause the inflammation in the spinal cord or whether the bacteria cause an autoimmune reaction in the immune system. This means that the cells of the immune system can erroneously fight the spinal cord as well as the pathogens and thus cause the inflammation.

Bacterial pathogens that are known to cause such inflammation are the tuberculosis pathogens, Borrelia bacteria but also so-called mycoplasmas. These must be treated with special antibiotic therapies. The earlier the infection is detected, the sooner a quick cure can be expected.

Viruses represent a second possibility of an infectiological cause of the spinal cord inflammation. Viral pathogens are responsible for this disease much more frequently than bacteria. The typical viruses that are often behind it range from childhood viruses, such as measles and mumps, through very common pathogens such as herpes or Eppstein-Barr viruses, to rabies and HIV pathogens.

The subsequent therapy must be made dependent on the respective virus. Some of the viruses can be controlled, but are not curable. These include the herpes viruses and HIV.

Measles or hepatitis viruses, on the other hand, can often be completely eliminated by the body. Supportive antiviral drugs can speed up the healing process and relieve symptoms. Multiple sclerosis (MS) is a chronic inflammatory disease in which the nerve fiber sheaths of the central nervous system (brain and spinal cord) are progressively destroyed.

If such centres of inflammation occur in the spinal cord without the diagnosis of MS already being known, they may well look like a separate inflammation of the spinal cord (myelitis) and initially be misinterpreted. Thus, symptoms of isolated myelitis can either be the early symptoms of a first MS relapse, or they can just as well represent a separate idiopathic inflammation of the spinal cord, which is unrelated to multiple sclerosis. Crucial for the diagnosis is CSF diagnostics (oligoclonal bands) and additional, inflammatory demyelination foci in brain tissue, which indicate a multiple sclerosis relapse.