In this article, we will discuss the Diagnosis of Acute Transverse Myelitis. So, let’s get started.
Investigations
The purpose of the investigations is to determine the site and the nature of the lesion.
TLC, DLC measure lymphocytosis. ESR may be raised.
X-ray chest to rule out tuberculosis or malignancy lung in patients suspected to be having tubercular myelitis or paraneoplastic syndrome.
X-ray spine (dorsal/lumbosacral) may show an evidence of tubercular osteitis if acute tubercular myelitis a suspected, otherwise X-ray spines are noncontributory.
MRI: It is an ideal investigation for detecting the areas of the demyelination, diagnosing myelitis or cord swelling due to inflammatory or toxic myelopathy. MRI distinguishes myelitis from other causes of compressive myelopathy.
CSF examination: Ideally an MRI scan should precede lumbar puncture to rule out compressive myelopathy (spinal cord compression). The CSF findings in myelitis may be normal aur may show rise in CSF protein with mononuclear cells. Initially there may be polymorphonuclear pleocytosis. The oligoclonal banding is a variable finding; when present, is associated with future evolution of multiple sclerosis.
Visual evoked potential: There may be accompanying optic neuritis if myelitis is suspected to be a part of demyelinating disease (Devic’s disease).