Ask the Expert 1408. Open Q&A on Transverse Myelitis (TM)

Krissy Dilger of SRNA welcomed University of Washington neuroimmunologist Dr. Shuvro Roy for an open Q&A on transverse myelitis (TM). Dr. Roy explained how TM can be both a presentation and a diagnosis, with “idiopathic TM” used when extensive testing finds no underlying cause, and noted that recurrence should prompt reevaluation for conditions like NMOSD, MOGAD, or neurosarcoidosis and consideration of preventive immunotherapy [00:06:16]. He addressed audience questions about lifestyle and rehabilitation topics including diet, metabolic health, exercise, sleep issues, and safe considerations around CBD or THC-containing gummies, and reviewed approaches to chronic pain, spasticity, physical therapy timelines, and spinal cord stimulation (including ArcX) [00:13:20]. Dr. Roy also discussed the current status of peptides and stem cells, highlighted emerging cell-based therapies like CAR-T, and answered a case question about a high MOG antibody titer and its diagnostic implications [00:24:53]. Shuvro Roy, MD is an Assistant Professor of Neurology at the University of Washington, specializing in neuroimmunology, with a specific focus on multiple sclerosis (MS) and related neuroimmunologic disorders. He is Co-Director of the UW SRNA Center of Excellence for Rare Neuroimmune disorders. He is also a core teaching faculty member for the UW Medicine Multiple Sclerosis Center’s fellowship program, contributing to clinical education and research initiatives like the ECHO MS program in collaboration with the National MS Society. Dr. Roy is actively engaged in projects aimed at improving access to care, addressing healthcare disparities, and enhancing patient safety for individuals living with MS and related conditions. He has co-authored recent research articles in medical journals on a variety of topics, including studies on stiff person syndrome, encephalomyelitis, MOG-antibody disorder, and multiple sclerosis treatment protocols. Dr. Roy is dedicated to helping his patients thrive amid challenging, lifelong neurological conditions. 00:00:00 Welcome and Introductions 00:01:24 What Is Transverse Myelitis 00:03:30 Common Causes and Mechanisms 00:06:16 Diagnosis Versus Presentation 00:10:39 Monophasic or Recurrent 00:13:20 Diet Do’s and Don’ts 00:17:25 Aging and Long-Term Health 00:24:53 Peptides and Stem Cells 00:33:07 Fatigue Sleep and CBD or THC-containing gummies 00:37:58 Chronic Pain Options 00:43:55 Physical Therapy Recovery 00:47:56 Spinal Cord Stimulation ArcX 00:51:46 Stopping Pregabalin Safely 00:52:59 Trials and Rehab at Any Age 00:56:00 MOG Titer and Diagnosis 01:00:02 Closing