• Information
• Publications
  • Brain and Spine Booklets
  • About our publications
  • Reader's Panel
  • Case studies
• Children's resources
• Neurological centres
• Spinal Injuries units
• Glossary
• Information Access toolkit
• Communication skills project

|

The combination of leg weakness and abnormal sensation on the trunk below the arms is a typical sign of a thoracic spinal cord problem whatever the cause. There may be an effect on bladder function; the bladder may be overfilled with urine and may be able to be felt in the abdomen. The main condition to rule out is something pressing on the spinal cord because specific treatment for this would be required.

Investigations are carried out urgently and usually involve an MRI scan. When pressure on the spinal cord has been ruled out, a lumbar puncture will normally be carried out (see below). A blood sample will be taken and tested to look for evidence of virus infection and to rule out other diseases. An MRI scan of the brain may also be carried out to rule out more widespread inflammation.

MRI (magnetic resonance imaging) scan
MRI is the method of choice (when available) for ruling out conditions that put pressure on the spinal cord e.g. tumours, or spinal cord damage caused by abnormal collections of blood vessels (called arteriovenous malformations). Images are produced using high-powered magnetic fields, microwave radiation and computers. The scan is painless and the magnetic fields do not have harmful effects, however the machine is rather noisy and some people find the process claustrophobic. In many cases, the areas of localised inflammation in the spinal cord can be seen on the scan pictures.

Magnetic resonance image (MRI) of the thoracic region of the spinal cord of a person with transverse myelitis. The lighter area within the spinal cord (arrowed) is the localised inflammation that caused severe leg weakness, inability to walk and difficulty passing urine. The patient made a full recovery. The very white area surrounding the length of the spinal cord is the cerebrospinal fluid (CSF). The CSF and spinal cord are enclosed in the spinal canal by the bones of the vertebra, seven of which are shown in this picture.

Lumbar puncture
In this test a small amount of the clear cerebrospinal fluid that surrounds the brain and spinal cord is removed from the lower back via a fine needle. Some people find this procedure a bit uncomfortable, although a small injection of local anaesthetic is given to first numb the area. Your doctor will probably ask you to curl up on your side while the fluid is taken. Getting into the right position helps to open up the gap between the two lumbar vertebra (spinal bones) through which the needle passes. You may be asked to lie flat for between one and three hours after the procedure to prevent headache.

Registered charity no. 1098528 | Site by Torchbox

Last updated 15 June 2009