A doctor will diagnose transverse myelitis based on your answers to questions about your signs and symptoms, your medical history, a clinical assessment of nerve function, and test results.
Magnetic resonance imaging (MRI) uses a magnetic field and radio waves to create 3-D images of soft tissues. An MRI can show inflammation of the spinal cord, and other potential causes of the symptoms, including abnormalities affecting the spinal cord or blood vessels.
Lumbar puncture (spinal tap) uses a needle to draw a small amount of cerebrospinal fluid (CSF), the protective fluid that surrounds your spinal cord and brain.
Other blood tests can identify infections that may contribute to transverse myelitis, or rule out other causes of symptoms.
Intravenous steroids. You'll probably receive steroids through a vein in your arm over the course of several days. Steroids help reduce the inflammation in your spinal column.
Plasma exchange therapy. People who don't respond to intravenous steroids may need plasma exchange therapy. This involves removing the straw-colored fluid in which blood cells are suspended (plasma) and replacing the plasma with special fluids.
It's not certain how this therapy helps people with transverse myelitis, but it may be that plasma exchange removes inflammatory antibodies.
Antiviral medication. Some people who have a viral infection of the spinal cord may be treated with medications to treat the virus.
Medications to prevent recurrent attacks of transverse myelitis. People who have antibodies associated with neuromyelitis optica need ongoing medications, such as corticosteroids and/or immunosuppressants, to reduce their chances of more transverse myelitis attacks or developing optic neuritis.
Physical therapy. This helps improve strength and coordination. Your physical therapist can teach you how to use any needed assistive devices, such as a wheelchair, canes or braces.
Occupational therapy. This helps people with transverse myelitis learn new ways of performing day-to-day activities, such as bathing, preparing a meal and housecleaning.
Psychotherapy. A psychotherapist can use talk therapy to treat anxiety, depression, sexual dysfunction, and other emotional or behavioral issues from coping with transverse myelitis.
Although most people with transverse myelitis have at least partial recovery, it may take a year or more. Most recovery occurs within the first three months after the episode and strongly depends on the cause of transverse myelitis.
No or slight disability. These people experience only minimal lingering symptoms.
Severe disability. Some people may permanently need a wheelchair and require ongoing assistance with daily care and activities.
It's difficult to predict the course of transverse myelitis. Generally, people who experience a rapid onset of signs and symptoms have a worse prognosis than do those with a relatively slower onset.
Signs and symptoms that might indicate transverse myelitis are usually severe and sudden. You'll likely need emergency or urgent care.