neurologic disorders
Acute Transverse Myelitis
Diagnosis of Acute Transverse Myelitis
MRI and cerebrospinal fluid (CSF) analysis Other tests to identify treatable causes Diagnosis of acute transverse myelitis is suggested by transverse sensorimotor myelopathy with segmental deficits. Guillain-Barré Syndrome (GBS) can be distinguished because it does not localize to a specific spinal segment. Diagnosis requires MRI and CSF analysis. MRI typically shows cord swelling if transverse myelitis is present and can help exclude other treatable causes of spinal cord dysfunction (eg, Spinal Cord Compression ). CSF usually contains monocytes, protein content is slightly increased, and IgG index is elevated (normal, A test for a marker for neuromyelitis optica IgG (NMO-IgG)—an autoantibody that targets the astrocyte water channel protein aquaporin-4—is highly specific and helps distinguish Diagnosis from Tests for treatable causes should include chest x-ray; PPD (purified protein derivative) for tuberculosis; serologic tests for mycoplasma, Lyme disease, COVID-19, and HIV; erythrocyte sedimentation rate (ESR) and/or C-reactive protein (CRP); antinuclear antibodies; and CSF and blood Venereal Disease Research Laboratory (VDRL) tests. History may suggest a medication or recreational drug as a cause. The differential diagnosis of acute transverse myelitis includes other transverse myelopathies due to nutritional deficiencies (eg, deficiency of vitamin B12, folate, zinc, orcopper), vascular insufficiency, and intraspinal tumors. Brain MRI is done; multiple sclerosis develops in 50% of patients who have multiple periventricular T2 bright lesions and in 5% who do not have them. 