Causes of longtitudinally extensive transverse myelitis
| Aetiology | Diagnosis | Diagnostic markers |
|---|---|---|
| Infective | Bacterial, eg, Lyme disease, tuberculosis and syphilis | Serology, culture and PCR on blood and CSF |
| Viral, eg, herpes virus, HIV | Serology and PCR on blood and CSF | |
| Inflammatory | Multiple sclerosis | MRI brain; positive CSF oligoclonal bands |
| Neuromyelitis optica (NMO) | Positive serum NMO IgG | |
| Sarcoidosis | Raised serum ACE/urinary calcium; granulomas on lymph node biopsy | |
| Systemic lupus erythematosus | Positive anti-nuclear antibody, anti-dsDNA and anti-phospholipid antibodies | |
| Sjögren's syndrome | Positive anti-nuclear antibody, anti-Ro and anti-La antibodies; lip biopsy | |
| Neoplastic | CNS tumours, eg, astrocytoma, ependymoma | MRI, biopsy |
| Paraneoplastic | Positron emission tomography scan, onconeuronal antibodies | |
| Metabolic | Vitamin B12 deficiency | Serum B12/methylmalonic acid levels |
| Copper deficiency | Serum copper levels | |
| Vascular | Spinal cord infarction | MRI, history |
| Spinal cord arteriovenous malformation | MRI/angiogram | |
| Trauma | Spinal cord contusion | MRI, history |
CNS, central nervous system.