Table 1

Causes of longtitudinally extensive transverse myelitis

AetiologyDiagnosisDiagnostic markers
InfectiveBacterial, eg, Lyme disease, tuberculosis and syphilisSerology, culture and PCR on blood and CSF
Viral, eg, herpes virus, HIVSerology and PCR on blood and CSF
InflammatoryMultiple sclerosisMRI brain; positive CSF oligoclonal bands
Neuromyelitis optica (NMO)Positive serum NMO IgG
SarcoidosisRaised serum ACE/urinary calcium; granulomas on lymph node biopsy
Systemic lupus erythematosusPositive anti-nuclear antibody, anti-dsDNA and anti-phospholipid antibodies
Sjögren's syndromePositive anti-nuclear antibody, anti-Ro and anti-La antibodies; lip biopsy
NeoplasticCNS tumours, eg, astrocytoma, ependymomaMRI, biopsy
ParaneoplasticPositron emission tomography scan, onconeuronal antibodies
MetabolicVitamin B12 deficiencySerum B12/methylmalonic acid levels
Copper deficiencySerum copper levels
VascularSpinal cord infarctionMRI, history
Spinal cord arteriovenous malformationMRI/angiogram
TraumaSpinal cord contusionMRI, history
  • CNS, central nervous system.