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Tests and diagnosis
By Mayo Clinic staffYour doctor may suspect transverse myelitis if you report weakness in your arms or legs, pain, changes in sensation, and problems with bowel or bladder function. Your doctor will ask about your medical history, including any recent illnesses or vaccinations. Reaching a diagnosis of transverse myelitis also requires evidence of inflammation within your spinal cord. Your doctor may determine this with several tests:
- Magnetic resonance imaging (MRI). An MRI scan is a test that uses a magnetic field and pulses of radio wave energy to make pictures of your body. If you have transverse myelitis, an MRI of your brain and spinal cord may show inflammation.
- Lumbar puncture. This test, also called a spinal tap, is used to collect a small amount of the fluid that surrounds your spinal cord and brain. During this test, your doctor injects a numbing medicine into your lower spine and then inserts a needle into your spinal canal to measure the fluid pressure and collect a sample. Some people with transverse myelitis may have abnormally high numbers of white blood cells or protein in the fluid, suggesting an infection or an inflammation. Spinal fluid can also be tested for viruses, the possibility of multiple sclerosis or the presence of certain cancers.
- Blood test. A blood test called an NMO-IgG test checks for antibodies for neuromyelitis optica, a condition in which inflammation occurs both in your spinal cord and in the nerve in your eye. People with a positive test for NMO-IgG are at an increased risk of experiencing multiple attacks of transverse myelitis.
In addition, your doctor may order blood tests to rule out other disorders that cause similar signs and symptoms.
Depending on the results of your MRI scan, other radiology tests may be necessary. For example, your doctor may request a myelogram or angiogram of your spinal cord to search for abnormal blood vessels. Rarely, you may need a biopsy of your spinal cord.
- Transverse myelitis fact sheet. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/transversemyelitis/detail_transversemyelitis.htm. Accessed Nov. 1, 2008.
- Eisen A. Disorders affecting the spinal cord. http://www.uptodate.com/home/index.html. Accessed Nov. 1, 2008.
- Kerr D. Transverse myelitis. In: Johnson RT, et al. Current Therapy in Neurologic Disease. 6th ed. Philadelphia, Pa.: C.V. Mosby; 2001. http://www.scribd.com/doc/2581918/KerrCurrent-therapy-chapter-with-figures. Accessed Nov. 1, 2008.
- Petti CA. Molecular diagnosis of central nervous system infections. http://www.uptodate.com/home/index.html. Accessed Nov. 1, 2008.
- Acute transverse myelitis. The Merck Manuals Online Medical Library: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/sec16/ch224/ch224b.html. Accessed Nov. 1, 2008.
- Weinshenker BG, et al. Neuromyelitis optica IgG predicts relapse following longitudinally extensive transverse myelitis. Annals of Neurology: 2006;59:566.
- Jacob A, et al. An approach to the diagnosis of acute transverse myelitis. Seminars in Neurology. 2008; 28(1):105.
- Weinshenker BG [expert opinion]. Mayo Clinic, Rochester, Minn. Oct 6, 2008.
