Short answer · Medically reviewed summary · Last updated: 2026-04-08
TL;DR: Transverse myelitis is a rare neurological disorder caused by inflammation across both sides of one level, or segment, of the spinal cord. While the exact cause is often unknown—a state referred to as idiopathic—it is frequently triggered by an abnormal immune system response to viral infections, autoimmune disorders, or other inflammatory conditions. What triggers Transverse myelitis? The underlying mechanism of Transverse myelitis involves the body’s immune system attacking the myelin sheath, the protective insulating layer around nerve fibers in the spinal cord.
20 people with Transverse myelitis have shared their first-person experience on this question at DiseaseMaps.
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Which are the causes of Transverse myelitis?
Causes of Transverse myelitis explained: genetic and environmental factors, reviewed against medical sources, plus patient perspectives.
TL;DR: Transverse myelitis is a rare neurological disorder caused by inflammation across both sides of one level, or segment, of the spinal cord. While the exact cause is often unknown—a state referred to as idiopathic—it is frequently triggered by an abnormal immune system response to viral infections, autoimmune disorders, or other inflammatory conditions.
What triggers Transverse myelitis?
The underlying mechanism of Transverse myelitis involves the body’s immune system attacking the myelin sheath, the protective insulating layer around nerve fibers in the spinal cord. When this "insulation" is damaged, the electrical signals sent from the brain to the rest of the body are interrupted, leading to the characteristic muscle weakness, sensory loss, and bladder or bowel dysfunction. Research suggests that Transverse myelitis is rarely a primary disease itself; rather, it is often a manifestation of an underlying process where the immune system mistakenly targets spinal tissue.
Is Transverse myelitis hereditary?
Currently, there is no evidence that Transverse myelitis is a directly inherited genetic disease. Unlike conditions caused by a single, identifiable gene mutation, this disorder does not follow typical Mendelian inheritance patterns. While genetic factors may play a subtle role in predisposing an individual to autoimmune conditions, there is no specific "Transverse myelitis gene" that parents pass to their children. The condition is generally considered acquired rather than congenital.
What are the known causes and environmental triggers?
Medical researchers categorize the potential triggers of Transverse myelitis into several distinct groups. Understanding these triggers is essential for neurologists as they determine the best course of treatment:
- Viral Infections: Viruses such as varicella-zoster (chickenpox/shingles), Epstein-Barr, HIV, and West Nile virus have been linked to the onset of the condition.
- Autoimmune Disorders: Conditions like multiple sclerosis (MS), neuromyelitis optica (NMO), systemic lupus erythematosus, and Sjögren's syndrome are known to cause Transverse myelitis.
- Post-Vaccination: In very rare instances, the immune system may overreact following a vaccination, leading to inflammation of the spinal cord.
- Idiopathic cases: In approximately 15% to 30% of cases, clinicians are unable to identify a definitive trigger despite extensive testing.
What is the difference between a cause and a risk factor?
In the study of Transverse myelitis, a "cause" refers to the direct inflammatory process damaging the spinal cord, such as a specific viral infection. A "risk factor," however, is a condition or characteristic that increases the likelihood of developing the disease. For instance, having a pre-existing autoimmune diagnosis is a major risk factor for developing Transverse myelitis, even if the specific inflammatory event is triggered by a separate, later infection. Ongoing clinical research is currently focused on biomarkers that might help predict which patients are at higher risk for recurrence.
Next steps
- Consult a neurologist specializing in neuroimmunology to undergo a comprehensive diagnostic workup, including MRI imaging and lumbar puncture.
- Join the DiseaseMaps.org community, where over 790 members share their experiences with Transverse myelitis to find support and learn about management strategies.
- Maintain a detailed medical journal to track symptoms, potential triggers, and responses to treatments like steroid therapy or physical therapy.
- Discuss participation in clinical trials or research registries with your specialist to help advance the scientific understanding of this complex condition.
Medical disclaimer: This content is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment; always seek the advice of your physician or other qualified health provider.
References
- NIH Genetic and Rare Diseases Information Center (GARD): Transverse Myelitis.
- Orphanet: Transverse myelitis.
- The Transverse Myelitis Association (Spondylitis Association of America).
- National Institute of Neurological Disorders and Stroke (NINDS): Transverse Myelitis Fact Sheet.
Author: DiseaseMaps Editorial Team
Reviewed against authoritative medical sources (NIH GARD, Orphanet, OMIM)
Last updated: 2026-04-08
Sources cited: NIH Genetic and Rare Diseases Information Center (GARD): Transverse Myelitis. · Orphanet: Transverse myelitis. · The Transverse Myelitis Association (Spondylitis Association of America). · National Institute of Neurological Disorders and Stroke (NINDS): Transverse Myelitis Fact Sheet.
Medical disclaimer:
This information does not substitute professional medical advice. Always consult your doctor before making health decisions.
Source:
DiseaseMaps.org
The exact cause of transverse myelitis and extensive damage to the bundles
of nerve fibers of the spinal cord is unknown in many cases. Cases in which a cause cannot be identified are called idiopathic. Viral, bacterial, and fungal infections affecting the spinal cord may cause the disorder.
A number of conditions appear to cause transverse myelitis, including:
Immune system disorders appear to play an important role in causing damage to the spinal cord. Such disorders are:
aquaporin-4 autoantibody associated neuromyelitis optica. Neuromyelitis optica is a disorder that affects the eye nerves and spinal cord. Aquaporin-4 is a channel on the cell membrane that lets water enter the cell and helps maintain the chemical balance for processes to take place within the central nervous system. An antibody is a protein that binds to foreign substances that can attack the host organism.
multiple sclerosis, a disorder in which immune system cells that normally protect us from viruses, bacteria, and unhealthy cells mistakenly attack the protective coating of myelin in the brain, optic nerves, and spinal cord
post-infectious or post-vaccine autoimmune phenomenon, in which the body’s immune system mistakenly attacks the body’s own tissue while responding to the infection or, less commonly, a vaccine
an abnormal immune response to an underlying cancer that damages the nervous system; or
other antibody-mediated conditions that are still being discovered.
Viral infections including herpes viruses such as varicella zoster (the virus that causes chickenpox and shingles), herpes simplex, cytomegalovirus, and Epstein-Barr; flaviviruses such as West Nile and Zika; influenza, echovirus, hepatitis B, mumps, measles, and rubella. It is often difficult to know whether direct viral infection or a post-infectious response causes the transverse myelitis.
Bacterial infections such as syphilis, tuberculosis, actinomyces, pertussis, tetanus, diphtheria,and Lyme disease. Bacterial skin infections, middle-ear infections, campylobacter jejuni gastroenteritis, and mycoplasma bacterial pneumonia have also been associated with the condition.
Fungal infections in the spinal cord, including aspergillus, blastomyces, coccidioides, and cryptococcus.
Parasites, including toxoplasmosis, cysticercosis, shistosomiasis, and angtiostrongyloides.
Other inflammatory disorders that can affect the spinal cord, such as sarcoidosis, systemic lupus erythematosus, Sjogren’s syndrome, mixed connective tissue disease, scleroderma, and Bechet’s syndrome.
Vascular disorders such as arteriovenous malformation, dural arterial-venous fistula, intra-spinal cavernous malformations, or disk embolism.
In some people, transverse myelitis represents the first symptom of an autoimmune or immune-mediated disease such as multiple sclerosis or neuromyelitis optica.“Partial” myelitis—affecting only a portion of the cord cross-section—is more characteristic of multiple sclerosis. Neuromyelitis optica is much more likely as an underlying condition when the myelitis is “complete” (causing severe paralysis and numbness on both sides of the spinal cord). Myelitis attacks with neuromyelitis optica spectrum disorder (NMOSD) tend to be more severe and are associated with less recovery than attacks with multiple sclerosis.
of nerve fibers of the spinal cord is unknown in many cases. Cases in which a cause cannot be identified are called idiopathic. Viral, bacterial, and fungal infections affecting the spinal cord may cause the disorder.
A number of conditions appear to cause transverse myelitis, including:
Immune system disorders appear to play an important role in causing damage to the spinal cord. Such disorders are:
aquaporin-4 autoantibody associated neuromyelitis optica. Neuromyelitis optica is a disorder that affects the eye nerves and spinal cord. Aquaporin-4 is a channel on the cell membrane that lets water enter the cell and helps maintain the chemical balance for processes to take place within the central nervous system. An antibody is a protein that binds to foreign substances that can attack the host organism.
multiple sclerosis, a disorder in which immune system cells that normally protect us from viruses, bacteria, and unhealthy cells mistakenly attack the protective coating of myelin in the brain, optic nerves, and spinal cord
post-infectious or post-vaccine autoimmune phenomenon, in which the body’s immune system mistakenly attacks the body’s own tissue while responding to the infection or, less commonly, a vaccine
an abnormal immune response to an underlying cancer that damages the nervous system; or
other antibody-mediated conditions that are still being discovered.
Viral infections including herpes viruses such as varicella zoster (the virus that causes chickenpox and shingles), herpes simplex, cytomegalovirus, and Epstein-Barr; flaviviruses such as West Nile and Zika; influenza, echovirus, hepatitis B, mumps, measles, and rubella. It is often difficult to know whether direct viral infection or a post-infectious response causes the transverse myelitis.
Bacterial infections such as syphilis, tuberculosis, actinomyces, pertussis, tetanus, diphtheria,and Lyme disease. Bacterial skin infections, middle-ear infections, campylobacter jejuni gastroenteritis, and mycoplasma bacterial pneumonia have also been associated with the condition.
Fungal infections in the spinal cord, including aspergillus, blastomyces, coccidioides, and cryptococcus.
Parasites, including toxoplasmosis, cysticercosis, shistosomiasis, and angtiostrongyloides.
Other inflammatory disorders that can affect the spinal cord, such as sarcoidosis, systemic lupus erythematosus, Sjogren’s syndrome, mixed connective tissue disease, scleroderma, and Bechet’s syndrome.
Vascular disorders such as arteriovenous malformation, dural arterial-venous fistula, intra-spinal cavernous malformations, or disk embolism.
In some people, transverse myelitis represents the first symptom of an autoimmune or immune-mediated disease such as multiple sclerosis or neuromyelitis optica.“Partial” myelitis—affecting only a portion of the cord cross-section—is more characteristic of multiple sclerosis. Neuromyelitis optica is much more likely as an underlying condition when the myelitis is “complete” (causing severe paralysis and numbness on both sides of the spinal cord). Myelitis attacks with neuromyelitis optica spectrum disorder (NMOSD) tend to be more severe and are associated with less recovery than attacks with multiple sclerosis.
Posted Aug 16, 2022 by Transverse Myelitis Folks Blue Crew
In 2005 when I was initially diagnosed with transverse myelitis and it was determined that it was not related to viral or bacterial rather autoimmune disease related, immediately had red flags and after doing research I discovered that the elements of which are causing rare autoimmune diseases or diseases spread for bacterial and viral infections are often caused by pollution in our environment are water or soil all of the foods were exposed to that are chemically processed and chemicals added to foods and drinks. In addition I believe that through a variety of contact with pollutants and minerals containing metal slowly our bodies start to break down immune systems breakdown and people become more susceptible two Contracting either autoimmune disease related transverse myelitis or become in contact and susceptible to infection through bacterial or viral. I do my best to live very healthy and natural as possible but regardless of my efforts I am inundated with all these elements every day as we all are, I don't know if there's a way to escape it.
Posted Feb 23, 2017 by Jen 1001
At the minute the causes are unknown but trigger causes seems to be flu vaccinations and viruses!
Posted Feb 23, 2017 by Cathy 1000
TM is said to be caused as a reaction to a virus (my case) as a response to vaccination or can just occur for no good reason.
In my case, I have had two lots of major brain surgery, the most recent being November 16. I became ill in early Feb 17, could it be that my body was weak following surgery? My immune system low? I just don't know but I developed a nasty virus which the doctors say attacked my central nervous system and from there TM developed.
In my case, I have had two lots of major brain surgery, the most recent being November 16. I became ill in early Feb 17, could it be that my body was weak following surgery? My immune system low? I just don't know but I developed a nasty virus which the doctors say attacked my central nervous system and from there TM developed.
Posted May 17, 2017 by Marella Cairns 1050
Flu vaccines, shingles attacks, pesticides, and fertilizers cause immune supression problems
Posted May 17, 2017 by Justin 1152
The exact cause for transverse myelitis is not known, although the inflammation is thought to be the result of the immune system mistakenly attacking the spinal cord. This is called an autoimmune reaction. When a cause cannot be identified, it is called idiopathic transverse myelitis.
Transverse myelitis often develops at the same time as, or soon after, a viral or bacterial infection. These cases are also believed to be the result of an autoimmune reaction. Rather than the viral or bacterial infection itself directly causing the inflammation, it is thought that the immune system which is stimulated to fight the infection, mistakenly, also attacks the spinal cord. In rare cases, vaccinations may be associated with transverse myelitis, although the underlying cause has not been proven.
It is thought that the immune system is triggered to respond to the vaccination and mistakenly attacks the spinal cord.
For some people, transverse myelitis can be linked to autoimmune diseases such as lupus, HIV, HTLV virus, vitamin B12 deficiency, MS and systemic lupus erythematosus (SLE), Lyme disease, syphilis, and some cancers (which can cause an autoimmune reaction) although this is rare.
In some cases, transverse myelitis may occur because of other disorders, such as multiple sclerosis (MS) and neuromyelitis optica (NMO). People with transverse myelitis should be evaluated for MS and NMO, as these may require different treatments. There is more information on transverse myelitis and MS and NMO in the 'Other demyelinating conditions' section
Transverse myelitis often develops at the same time as, or soon after, a viral or bacterial infection. These cases are also believed to be the result of an autoimmune reaction. Rather than the viral or bacterial infection itself directly causing the inflammation, it is thought that the immune system which is stimulated to fight the infection, mistakenly, also attacks the spinal cord. In rare cases, vaccinations may be associated with transverse myelitis, although the underlying cause has not been proven.
It is thought that the immune system is triggered to respond to the vaccination and mistakenly attacks the spinal cord.
For some people, transverse myelitis can be linked to autoimmune diseases such as lupus, HIV, HTLV virus, vitamin B12 deficiency, MS and systemic lupus erythematosus (SLE), Lyme disease, syphilis, and some cancers (which can cause an autoimmune reaction) although this is rare.
In some cases, transverse myelitis may occur because of other disorders, such as multiple sclerosis (MS) and neuromyelitis optica (NMO). People with transverse myelitis should be evaluated for MS and NMO, as these may require different treatments. There is more information on transverse myelitis and MS and NMO in the 'Other demyelinating conditions' section
Posted Jul 24, 2017 by Hagen 2730
most cases are idiopathic, without known cause
Posted Jul 25, 2017 by Mindy 2000
It is an auto-immune response to various factors.
Can be illness and the immune system goes into overdrive and attacks the spine or can be because of innoculations and the immune system once again attacks the spine.
Mine was a simple flu that caused my immune system to go into overdrive.
Can be illness and the immune system goes into overdrive and attacks the spine or can be because of innoculations and the immune system once again attacks the spine.
Mine was a simple flu that caused my immune system to go into overdrive.
Posted Jul 25, 2017 by Conrad 2200
Ypu can get TM from it being idiopathic which means unknown cause, from the cold or flu which then makes your immune system attack the spinal cord.
Posted Aug 24, 2017 by Elizabeth 1200
If not obvious, TM is often considered to be ideopathic (no known cause). It could be a reaction to a simple cold or virus. Could happen from getting a shot. i suppose it could come from environment such as poisoning. Whatever the cause, TM is an autoimmune disorder where your immune system goes into overdrive destroying the myelin surrounding nerves.
Posted Oct 6, 2017 by Chuck 2000
Viral or bacterial attacks on the nervous system from a depleted auto immune system. About 30% have no know causes (ideopathic) food poisoning can cause it.
Posted Nov 30, 2017 by mikado54mark 3150
Most cases of Transverse Myelitis are idiopathic meaning cause unknown. There is research into causes and some people believe that vaccines or infection can be a source. But my belief is whatever the cause there is no cure so I ‘just get on with it’.
Posted Feb 27, 2018 by Gill 1800
It is a swelling of the myelin sheath surrounding your spine. Many times MS can cause it, but it can come from other sources that are vascular in nature or from the autoimmune system producing antibodies that attack the spine.
Posted Jun 1, 2018 by Clay Garner 2500
I was constantly asked did I have a cold or vaccine which I didn't but personally I think it was my gum disease.
Posted Jun 1, 2021 by Gary 3550
The exact cause of transverse myelitis and extensive damage to the bundles of nerve fibers of the spinal cord is unknown in many cases. Cases in which a cause cannot be identified are called idiopathic. Viral, bacterial, and fungal infections affecting the spinal cord may cause the disorder.
A number of conditions appear to cause transverse myelitis, including:
Immune system disorders appear to play an important role in causing damage to the spinal cord. Such disorders are:
aquaporin-4 autoantibody associated neuromyelitis optica. Neuromyelitis optica is a disorder that affects the eye nerves and spinal cord. Aquaporin-4 is a channel on the cell membrane that lets water enter the cell and helps maintain the chemical balance for processes to take place within the central nervous system. An antibody is a protein that binds to foreign substances that can attack the host organism.
multiple sclerosis, a disorder in which immune system cells that normally protect us from viruses, bacteria, and unhealthy cells mistakenly attack the protective coating of myelin in the brain, optic nerves, and spinal cord
post-infectious or post-vaccine autoimmune phenomenon, in which the body’s immune system mistakenly attacks the body’s own tissue while responding to the infection or, less commonly, a vaccine an abnormal immune response to an underlying cancer that damages the nervous system; or other antibody-mediated conditions that are still being discovered.
Viral infections including herpes viruses such as varicella zoster (the virus that causes chickenpox and shingles), herpes simplex, cytomegalovirus, and Epstein-Barr; flaviviruses such as West Nile and Zika; influenza, echovirus, hepatitis B, mumps, measles, and rubella. It is often difficult to know whether direct viral infection or a post-infectious response causes the transverse myelitis.
Bacterial infections such as syphilis, tuberculosis, actinomyces, pertussis, tetanus, diphtheria,and Lyme disease. Bacterial skin infections, middle-ear infections, campylobacter jejuni gastroenteritis, and mycoplasma bacterial pneumonia have also been associated with the condition.
Fungal infections in the spinal cord, including aspergillus, blastomyces, coccidioides, and cryptococcus.
Parasites, including toxoplasmosis, cysticercosis, shistosomiasis, and angtiostrongyloides.
Other inflammatory disorders that can affect the spinal cord, such as sarcoidosis, systemic lupus erythematosus, Sjogren’s syndrome, mixed connective tissue disease, scleroderma, and Bechet’s syndrome.
Vascular disorders such as arteriovenous malformation, dural arterial-venous fistula, intra-spinal cavernous malformations, or disk embolism.
In some people, transverse myelitis represents the first symptom of an autoimmune or immune-mediated disease such as multiple sclerosis or neuromyelitis optica.“Partial” myelitis—affecting only a portion of the cord cross-section—is more characteristic of multiple sclerosis. Neuromyelitis optica is much more likely as an underlying condition when the myelitis is “complete” (causing severe paralysis and numbness on both sides of the spinal cord). Myelitis attacks with neuromyelitis optica spectrum disorder (NMOSD) tend to be more severe and are associated with less recovery than attacks with multiple sclerosis.
A number of conditions appear to cause transverse myelitis, including:
Immune system disorders appear to play an important role in causing damage to the spinal cord. Such disorders are:
aquaporin-4 autoantibody associated neuromyelitis optica. Neuromyelitis optica is a disorder that affects the eye nerves and spinal cord. Aquaporin-4 is a channel on the cell membrane that lets water enter the cell and helps maintain the chemical balance for processes to take place within the central nervous system. An antibody is a protein that binds to foreign substances that can attack the host organism.
multiple sclerosis, a disorder in which immune system cells that normally protect us from viruses, bacteria, and unhealthy cells mistakenly attack the protective coating of myelin in the brain, optic nerves, and spinal cord
post-infectious or post-vaccine autoimmune phenomenon, in which the body’s immune system mistakenly attacks the body’s own tissue while responding to the infection or, less commonly, a vaccine an abnormal immune response to an underlying cancer that damages the nervous system; or other antibody-mediated conditions that are still being discovered.
Viral infections including herpes viruses such as varicella zoster (the virus that causes chickenpox and shingles), herpes simplex, cytomegalovirus, and Epstein-Barr; flaviviruses such as West Nile and Zika; influenza, echovirus, hepatitis B, mumps, measles, and rubella. It is often difficult to know whether direct viral infection or a post-infectious response causes the transverse myelitis.
Bacterial infections such as syphilis, tuberculosis, actinomyces, pertussis, tetanus, diphtheria,and Lyme disease. Bacterial skin infections, middle-ear infections, campylobacter jejuni gastroenteritis, and mycoplasma bacterial pneumonia have also been associated with the condition.
Fungal infections in the spinal cord, including aspergillus, blastomyces, coccidioides, and cryptococcus.
Parasites, including toxoplasmosis, cysticercosis, shistosomiasis, and angtiostrongyloides.
Other inflammatory disorders that can affect the spinal cord, such as sarcoidosis, systemic lupus erythematosus, Sjogren’s syndrome, mixed connective tissue disease, scleroderma, and Bechet’s syndrome.
Vascular disorders such as arteriovenous malformation, dural arterial-venous fistula, intra-spinal cavernous malformations, or disk embolism.
In some people, transverse myelitis represents the first symptom of an autoimmune or immune-mediated disease such as multiple sclerosis or neuromyelitis optica.“Partial” myelitis—affecting only a portion of the cord cross-section—is more characteristic of multiple sclerosis. Neuromyelitis optica is much more likely as an underlying condition when the myelitis is “complete” (causing severe paralysis and numbness on both sides of the spinal cord). Myelitis attacks with neuromyelitis optica spectrum disorder (NMOSD) tend to be more severe and are associated with less recovery than attacks with multiple sclerosis.
Posted Aug 17, 2022 by Kevin Weilacher 3420
There are a number of infections and diseases that can cause TM.
Posted Aug 17, 2022 by gloria_kazan 7450
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Can be viral, vaccines or auto-immune or idiopatica
Posted May 29, 2017 by Adriana E. 2000
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I think that is a summation of all... food, environment, infections, lowered immunity, stress. The balance in the emotional life as the physical is the only prevention that we have.
Posted May 29, 2017 by Leandro 2200
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Do not know which are the reasons, some say due to bacteria, virus, lack of vid d, poor diet, smoking and environmental factors
Posted Aug 8, 2017 by Dani 2000
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Many
Lupus, multiple sclerosis, HIV, etc
Lupus, multiple sclerosis, HIV, etc
Posted Nov 8, 2017 by Lorena 3050
