Continuum (Minneap Minn). 2018 Apr;24(2, Spinal Cord Disorders):441-473. doi: 10.1212/CON.0000000000000597.
PURPOSE OF REVIEW:
This article reviews bacterial, viral, fungal, and parasitic pathogens associated with myelopathy. Infectious myelopathies may be due to direct infection or parainfectious autoimmune-mediated mechanisms; this article focuses primarily on the former.
Some microorganisms exhibit neurotropism for the spinal cord (eg, enteroviruses such as poliovirus and flaviviruses such as West Nile virus), while others are more protean in neurologic manifestations (eg, herpesviruses such as varicella-zoster virus), and others are only rarely reported to cause myelopathy (eg, certain fungal and parasitic infections). Individuals who are immunocompromised are at increased risk of disseminated infection to the central nervous system. Within the last few years, an enterovirus D68 outbreak has been associated with cases of acute flaccid paralysis in children, and emerging Zika virus infection has been concurrent with cases of acute flaccid paralysis due to Guillain-Barré syndrome, although cases of myelitis have also been reported. Associated pathogens differ by geographic distribution, with myelopathies related to Borrelia burgdorferi (Lyme disease) and West Nile virus more commonly seen in the United States and parasitic infections encountered more often in Latin America, Southeast Asia, and Africa. Characteristic CSF and MRI patterns have been identified with many of these infections.
A myriad of pathogens are associated with infectious myelopathies. Host factors, geographic distribution, clinical features, CSF profiles, and MRI findings can assist in formulating the differential diagnosis and ultimately guide management.
Myelopathy is a neurologic deficit related to the spinal cord which can be caused by trauma (spinal cord injury) or inflammation (myelitis). Inflammation can be caused by numerous things including pathogens such as Borrelia burgdorferi (Bb), the causative agent of Lyme Disease, as well as numerous viruses that can also be a part of the Lyme/MSIDS symptom picture which can be transmitted directly from ticks or activated due to the reaction of the body to the tick bite. Much research is needed in this particular area.
Myelopathy is typically a clinical diagnosis with patients complaining of weakness, clumsiness, muscle atrophy, sensory deficits, bowel/bladder symptoms, sexual dysfunction, altered tons, spasticity, and hyperreflexia among other symptoms. https://en.wikipedia.org/wiki/Myelopathy Treatment depends upon the underlying cause. If infectious, pathogen specific antibiotics, and/or things to reduce inflammation are in order.
Personal response: While I was not diagnosed with myelopathy specifically, one of my hallmark symptoms was spinal and occipital pain. After ruling out Chiari: https://madisonarealymesupportgroup.com/2016/04/02/chiari/ and regularly seeing an upper cervical chiropractor for structural malalignment, MSM helped me tremendously. Please read about MSM here: https://madisonarealymesupportgroup.com/2018/03/02/dmso-msm-for-lyme-msids/
Make sure to discuss all treatment options with your health care provider.