8010 - Myelitis

DBQ: Link to Index of DBQ/Exams by Disability for DC 8010 

Definition

Myelitis is a group of signs and symptoms characterized by an acute inflammation of the spinal cord.

Etiology

The cause of myelitis is unknown. In some instances, the condition may follow nonspecific viral infection or vaccination, which may relate to an immunologic cause. The following conditions include those that may be associated with myelitis: vasculitis; use of amphetamines or intravenous (IV) heroin; Lyme disease; syphilis; tuberculosis; multiple sclerosis or parasitic or fungal agents.

Signs & Symptoms

Signs and symptoms may progress over a period and then become severe. The manifestations may include: progressive weakness and numbness of the feet and legs; difficulty urinating; loss of appetite; and constipation followed by loss of bowel control. Local back pain, headache, and stiff neck may also characterize the condition. In addition, there may be pain in the back radiating to the limbs. Paralysis usually develops with numbness, tingling or burning, which may be in various stages of completeness.

Tests

Diagnostic measures may include: analysis of the cerebrospinal fluid (CSF); magnetic resonance imaging (MRI); myelography; and blood serum testing.

Treatment

Treatment for the condition is nonspecific and related to the symptoms. Associated conditions such as vasculitis are treated. Corticosteroids also may be given.

Residuals

Residuals may include the formation of bedsores (decubiti) as well as residual weakness, numbness, and inability to control urine and bowels. The syndrome may recur, and there may be varying degrees of disability associated with possible paralysis. Death may result if the condition moves upward and involves the respiratory muscles.

Special Considerations

  • In those cases where there is severe neurologic deficit, consider entitlement under 38 CFR 3.350 [Special monthly compensation ratings]; competency under 38 CFR 3.353 [Determinations of incompetency and competency]; and ancillary benefits under 38 CFR 3.807, 38 CFR 3.808 [Automobiles or other conveyances; certification], 38 CFR 3.809 [Specially adapted housing], and 38 CFR 3.809a [Special home adaptation grants].

  • This disease shall be granted service connection although not otherwise established as incurred in or aggravated by service if manifested to a compensable degree within the applicable time limits under 38 CFR 3.307 following service in a period of war or following peacetime service on or after January 1, 1947, provided the rebuttable presumption provisions of 38 CFR 3.307 are also satisfied [38 CFR 3.309 [Disease subject to presumptive service connection], 38 CFR 3.309(a) [chronic disease].

Notes

  • It is required for the minimum ratings for residuals under diagnostic codes 8000-8025, that there be ascertainable residuals. Determinations as to the presence of residuals not capable of objective verification, i.e., headaches, dizziness, fatigability, must be approached on the basis of the diagnosis recorded; subjective residuals will be accepted when consistent with the disease and not more likely attributable to other disease or no disease. It is of exceptional importance that when ratings in excess of the prescribed minimum ratings are assigned, the diagnostic codes utilized as bases of evaluation be cited, in addition to the codes identifying the diagnoses.

  • Disability in this field is ordinarily to be rated in proportion to the impairment of motor, sensory or mental function. Consider especially psychotic manifestations, complete or partial loss of use of one or more extremities, speech disturbances, impairment of vision, disturbances of gait, tremors, visceral manifestations, injury to the skull, etc. In rating disability from the conditions in the preceding sentence refer to the appropriate schedule. In rating peripheral nerve injuries and their residuals, attention should be given to the site and character of the injury, the relative impairment in motor function, trophic changes, or sensory disturbances.  38 CFR 4.120

  • With the exceptions noted, disability from the following diseases and their residuals may be rated from 10 percent to 100 percent in proportion to the impairment of motor, sensory, or mental function. Consider especially psychotic manifestations, complete or partial loss of use of one or more extremities, speech disturbances, impairment of vision, disturbances of gait, tremors, visceral manifestations, etc., referring to the appropriate bodily system of the schedule. With partial loss of use of one or more extremities from neurological lesions, rate by comparison with the mild, moderate, severe, or complete paralysis of peripheral nerves” 38 CFR 4.124a