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How is Transverse myelitis diagnosed?

See how Transverse myelitis is diagnosed. Which specialists are essential to meet, what tests are needed and other useful information for the diagnosis of Transverse myelitis

Transverse myelitis diagnosis

Transverse myelitis (TM) is a rare neurological condition characterized by inflammation of the spinal cord. It can affect individuals of any age, gender, or ethnicity. TM often presents with symptoms such as weakness, sensory disturbances, and pain in the affected areas of the body. Diagnosing TM requires a comprehensive evaluation that involves a combination of medical history, physical examination, and various diagnostic tests.



Medical History


The first step in diagnosing TM is obtaining a detailed medical history from the patient. The healthcare provider will ask questions about the onset and progression of symptoms, previous medical conditions, recent infections, vaccinations, exposure to toxins, and family history of neurological disorders. This information helps in understanding the potential causes and risk factors associated with TM.



Physical Examination


A thorough physical examination is crucial in assessing the neurological signs and symptoms of TM. The healthcare provider will evaluate muscle strength, reflexes, coordination, sensation, and other neurological functions. They will also look for any signs of inflammation or infection, such as fever or swelling. The physical examination helps in identifying the areas of the body affected by TM and ruling out other possible causes of the symptoms.



Diagnostic Tests


Several diagnostic tests are used to confirm the diagnosis of TM and exclude other conditions with similar symptoms. These tests may include:



Magnetic Resonance Imaging (MRI)


MRI is a key diagnostic tool for TM. It provides detailed images of the spinal cord, allowing healthcare professionals to visualize any inflammation or damage. In TM cases, MRI often reveals a characteristic pattern of inflammation extending across one or more segments of the spinal cord. This imaging technique helps in ruling out other spinal cord disorders and identifying the location and extent of the inflammation.



Lumbar Puncture (Spinal Tap)


Lumbar puncture involves the insertion of a needle into the lower back to collect a sample of cerebrospinal fluid (CSF) surrounding the spinal cord. Analysis of the CSF can help detect any signs of inflammation, infection, or abnormal antibodies associated with TM. Lumbar puncture is particularly useful in ruling out infectious causes of myelitis.



Blood Tests


A variety of blood tests may be performed to assess the overall health of the individual and identify potential underlying causes of TM. These tests can include a complete blood count (CBC), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), autoimmune markers, and tests for infectious agents such as viruses or bacteria.



Electromyography (EMG) and Nerve Conduction Studies (NCS)


EMG and NCS are tests that evaluate the electrical activity and function of muscles and nerves. They can help determine if the symptoms are due to nerve damage or dysfunction. These tests are often used to rule out other conditions that may mimic TM, such as peripheral neuropathy or nerve compression.



Evoked Potentials


Evoked potentials are tests that measure the electrical signals generated by the brain and spinal cord in response to specific stimuli. These tests can assess the conduction of nerve signals along the spinal cord and help identify any abnormalities. Visual evoked potentials (VEP), somatosensory evoked potentials (SSEP), and auditory brainstem response (ABR) are commonly used evoked potential tests in TM diagnosis.



Biopsy


In rare cases, a biopsy of the affected spinal cord tissue may be necessary to confirm the diagnosis of TM. This procedure involves the surgical removal of a small sample of tissue for microscopic examination. Biopsy is typically reserved for cases where other diagnostic tests are inconclusive or when an alternative diagnosis is suspected.



Conclusion


Diagnosing transverse myelitis requires a comprehensive approach that combines medical history, physical examination, and various diagnostic tests. The medical history and physical examination help in assessing the symptoms and ruling out other potential causes. Diagnostic tests such as MRI, lumbar puncture, blood tests, EMG/NCS, evoked potentials, and, in rare cases, biopsy, are used to confirm the diagnosis and determine the extent of spinal cord inflammation. Early and accurate diagnosis of TM is crucial for initiating appropriate treatment and managing the condition effectively.


Diseasemaps
29 answers
Diagnosis
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.

These tests, 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 3D 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.

Posted Aug 16, 2022 by Transverse Myelitis Folks Blue Crew
MRI

Posted Feb 23, 2017 by Nancy 715
Transverse myelitis is mostly diagnosed true route of elimination so most people have to go through every single test imaginable typically it's around 360 + blood screenings MRI from brain to tailbone with and without contrast along with spinal tap our typical for Diagnostic care the biggest issue is transverse myelitis is caused by several different things so it can be contracted through vaccine via viral it can be contracted through bacteria that attacks the central nervous system it can be contracted through autoimmune disease it can be and most likely an 85% or more people a transverse either have MS prior to itm attack or vice versa people after a transverse myelitis attack will develop MS. Also if transverse myelitis is caused by its own actual autoimmune disease you're far more likely to also develop systemic lupus and MS along with those attacks and the attacks are also able reoccur as well. The initial information that and data that was out was that 1/3 recover well 1/3 partially recovering 1/3 never recover those numbers have changed drastically. The current research is showing that we really only about 15 to 20% fully recover with no long-term effects and usually those people suffered very mild cases of inflammation in the spinal cord they may not have even and it up with a lesion on the cord it could have just been inflammation that was immediately found and brought back down by steroids the rest will suffer from permanent damage for the rest of their lives the other third that suffers from it being autoimmune disease related may experience many pallets of partial recovery but you never know when it's going to hit you again how hard it will hit you or how long it will last and if it's in combination with MS or systemic lupus those statistics of repairing or having remission is very small percentage because you're battling all 3 at the same time the body really has a reprieve.

Posted Feb 23, 2017 by Jen 1001
MRI Scans of the brain and Spine

Posted Feb 23, 2017 by Cathy 1000
It can be difficult to get a diagnosis initially, partially due to the disease rarity. Patients need to be referred to a neurologist as soon as possible, but this does not always happen (in the UK).

Symptoms can be aligned with other conditions such as cauda equina or Guillanne Barre syndrome, but further investigation will eliminate these. An MRI scan is usually need to give a definitive diagnosis, but the inflammatory changes can be quite subtle, so an expert in reading the scans is needed.

Other tests include blood tests and lumbar puncture. Lumbar puncture also can provide definitive diagnosis, however I declined to have this test.

Posted May 17, 2017 by Marella Cairns 1050
It needs to be diagnosed from a neurologist. Although your primary may be the first to notice the signs.

Posted May 17, 2017 by Justin 1152
If you are one of those people with acute TM where the condition has come on in a matter of hours, your GP will probably have referred you or you will have taken yourself to  A & E at your local hospital. It is estimated that there are only about 300 cases a year of TM in the UK. This means that your average GP will encounter a case once every 100 years so it is likely that your GP may not be familiar with TM. Diagnosis of TM relies on patient history, physical examination, MRI, lumbar puncture and blood tests. It is however, a rare condition and many neurology departments rely on once a week visits from a Regional Neuroscience Centre specialist. For some people, the diagnosis of TM may happen years after the original attack.

Posted Jul 24, 2017 by Hagen 2730
diagnosed with an MRI and a spinal tap.

Posted Jul 25, 2017 by Mindy 2000
MRI scan of the spine to review inflammation and level

Posted Jul 25, 2017 by Conrad 2200
MRI is performed to look at the spinal cord and you will have to do a spinal tap

Posted Aug 24, 2017 by Elizabeth 1200
MRI
Lumbar Punctures

Posted Sep 10, 2017 by Kevin Weilacher 3420
Through MRI or lumbar puncture

Posted Sep 10, 2017 by Barbara 400
MRI of spine. Most doctors do LP.

Posted Sep 10, 2017 by Amy 600
Usually by a combination of an MRI to show inflammation and an lumbar puncture.

Posted Sep 29, 2017 by Lindz1980 905
Imaging, such as CT scans and MRIs, and symptoms/health history.

Posted Sep 29, 2017 by Samantha Bryce 2065
It is very difficult to diagnose, and for me it was done by a process of elimination.

Posted Sep 30, 2017 by Kimberlee 300
An MRI will show the inflammation. A lumbar puncture will confirm presence of oligoclonal bands. TM is typically a one time deal. It is possible to have recurring TM but a recurrence might cause a change of dx to MS.

Posted Oct 6, 2017 by Chuck 2000
Its diagnosed via an MRI after the onset of symptoms. Its important for someone diagnosed with TM to get to a clinic of excellence as soon as possible.

Posted Nov 30, 2017 by mikado54mark 3150
My TM was diagnosed by process of elimination, they decided it wasn’t anything else, so gave me this dx ..

Posted Jan 18, 2018 by JoeyButler 500
The diagnosis of Transverse Myelitis depends upon the timeliness of the onset. For a sudden onset over a few hours (such as myself) the diagnosis is more straightforward as admission to hospital is very quick due to paralysis. The diagnosis is obtained by a neurological examination which is usually followed by a MRI scan, lumbar puncture (spinal tap) and then a 3 to 4 day course of intravenous steroids. For those with symptoms over many months the journey to diagnosis is not so straightforward as other tests may be carried out. But it is generally the MRI and bowel/bladder dysfunction that is the key.

Posted Feb 27, 2018 by Gill 1800
Usually as a result of testing spinal fluids and reviewing MRIs.

Posted Jun 1, 2018 by Clay Garner 2500
My team used to consist of an Nephrologist, Cardiologist, Neurologist, endocrinologist, podiatrist, optometrist.
Mri, plasma pherisis, spinal tap,

Posted Jun 1, 2021 by Gary 3550
It is diagnosed with MRI's, lumbar puncture and differential diagnosis.

Posted Aug 17, 2022 by gloria_kazan 7450
Translated from spanish Improve translation
Magnetic resonance imaging

Posted May 29, 2017 by Adriana E. 2000
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It is important to know that the pain of head and body is very important even if you do not have a fever. usually if you don't have a fever guard medical you're not taken with importance. This is a big difference in the time since if there is a resonance and a speedy medication becomes inflamed and destroys the myelin in hours, therefore you should make time everything.

Posted May 29, 2017 by Leandro 2200
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It is diagnosed through an mri and a lumbar puncture

Posted Aug 8, 2017 by Dani 2000
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By means of a lumbar puncture. With a neurologist

Posted Sep 14, 2017 by Franci 2000
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Through magnetic resonance imaging with contrast

Posted Nov 8, 2017 by Lorena 3050

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