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Transverse myelitis is not always a straightforward condition to diagnose.

People who experience a sudden onset of their symptoms are more likely to seek medical attention urgently and go straight to hospital. If your symptoms develop more slowly, you are more likely to see your GP. Your GP should refer you to a neurologist.

Your medical history will be checked and you will have a physical examination as part of your assessment. The combination of weakness in the legs and unusual sensations (paraesthesia) is a symptom of problems in the spinal cord whatever the cause. It is important to rule out any conditions which might be causing pressure on the spinal cord such as a slipped disc, an abscess, an abnormal collection of blood vessels (arteriovenous malformations), or a tumour. People with any of these conditions will require specific treatments for them.

As bladder problems are common with transverse myelitis, a doctor might physically examine you for signs of your bladder being overfilled with urine. This can be checked by feeling your stomach for signs of swelling.

You might also have blood tests to check for any underlying conditions or illness which might cause your symptoms.

MRI scan

The key test for transverse myelitis is an MRI scan.

An MRI scan produces pictures of the spine using strong magnetic fields and radio waves. It differs from a standard X-ray as it produces very detailed pictures. During the scan, you will lie in a long tube. The scan is painless but, unfortunately, the scanner is very noisy.

The results of the scan will be checked to rule out any conditions causing pressure on the spinal cord. The scan pictures will also be checked to look for any areas of inflammation in the spinal cord.

(You might be interested in reading our fact sheet on brain and spine scans for further information.)

Lumbar puncture

The spinal cord is surrounded by a clear liquid called cerebrospinal fluid (CSF). For some people with transverse myelitis, the signs of a possible infection are indicated by abnormalities in their CSF.

To take a sample of this fluid, a needle is passed between two vertebrae (spinal bones) at the lower end of the spine (the lumbar area) into the space containing the CSF. A small amount is drawn off in a syringe and sent to a laboratory for examination.

Some people find this procedure uncomfortable but you will be given a local anaesthetic first to numb the area. You might be asked to lie on your back for between one and three hours and to drink plenty of water afterwards to prevent getting a headache.

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Last updated 13 January 2011