Transverse Myelitis

If you’re experiencing symptoms of transverse myelitis (TM), your healthcare provider will review your medical history and perform a physical examination.

If this review suggests a problem with your spinal cord, they’ll order further tests to:

• Eliminate the possibility that something other than inflammation is affecting your spinal cord, such as a spinal tumor, herniated disc or compression caused by an abscess.
• Confirm the presence of abnormal inflammation within your spinal cord.
• Identify the cause of the abnormal inflammation, if possible.

Healthcare providers diagnose TM if you develop spinal cord symptoms over a few days and magnetic resonance imaging (MRI) or other imaging doesn’t show another cause for the spinal cord issues.

What tests will be done to diagnose transverse myelitis?

Your healthcare provider may order the following tests to diagnose transverse myelitis and its cause:

• MRI (magnetic resonance imaging) of your entire spine: MRI is a painless test that produces very clear images of the organs and structures within your body using a large magnet, radio waves and a computer to produce detailed images. You may need two spine MRIs — one with and one without gadolinium contrast so your healthcare provider can differentiate between compressive and noncompressive lesions.
• Brain MRI: Your healthcare provider may order a brain MRI with and without gadolinium contrast to evaluate for evidence of brain lesions. A brain MRI may provide clues to other underlying causes, especially multiple sclerosis.
• Spinal tap (lumbar puncture): To perform a spinal tap, your healthcare provider inserts a needle into your lower back to get a sample of cerebrospinal fluid (CSF). Cerebrospinal fluid is the clear liquid that surrounds your spine and brain. A laboratory then analyzes the CSF sample for elevated white blood cells or IgG index or the presence of oligoclonal IgG bands unique to the CSF. These inflammatory markers are common in TM.
• Blood tests: Your healthcare provider will likely order several blood tests to check for infection-related and immune system-related causes of TM.

You may need additional tests depending on the possible cause of TM. If none of these tests suggests a specific cause, you’re presumed to have idiopathic transverse myelitis.