Transverse myelitis (TM) is a pathogenetically heterogeneous focal inflammatory disorder of the spinal cord characterized by acute or subacute development of motor weakness, sensory impairment, and autonomic dysfunction. MRI of the spinal cord reveals a focal hyperintense lesion and cerebrospinal fluid usually shows pleocytosis. The causes of TM are heterogeneous, but partial TM (asymmetric, short cord lesions) is associated with multiple sclerosis, whereas longitudinally extensive lesions are associated with neuromyelitis optica spectrum disorders.
A doctor will diagnose transverse myelitis based on your answers to questions about your signs and symptoms, your medical history, a clinical assessment of nerve function, and test results.
Transverse Myelitis Diagnosis, which may indicate inflammation of the spinal cord and rule out other disorders, include the following:
- Magnetic resonance imaging (MRI) uses a magnetic field and radio waves to create 3-D images of soft tissues. An MRI can show inflammation of the spinal cord, and other potential causes of the symptoms, including abnormalities affecting the spinal cord or blood vessels.
- Lumbar puncture (spinal tap) uses a needle to draw a small amount of cerebrospinal fluid (CSF), the protective fluid that surrounds your spinal cord and brain.
- In some people with transverse myelitis, CSF may have abnormally high numbers of white blood cells or immune system proteins that indicate inflammation. Spinal fluid can also be tested for viral infections or certain cancers.
- Blood tests may include a test that checks for antibodies associated with neuromyelitis optica, a condition in which inflammation occurs both in your spinal cord and in the nerve in your eye. People with a positive antibody test are at increased risk of experiencing multiple attacks of transverse myelitis and require treatment to prevent future attacks.
- Other blood tests can identify infections that may contribute to transverse myelitis, or rule out other causes of symptoms.
If none of these Transverse Myelitis Diagnosis suggests a specific cause, the person is presumed to have idiopathic transverse myelitis. In occasional cases, initial testing using MRI and lumbar puncture may show normal results but may need to be repeated in 5-7 days.