Clinical features of transverse myelitis:
(1) bilateral clinical findings attributable to the spinal cord that may or may not be symmetric
(2) clearly defined sensory level
(3) progression to a nadir of clinical deficits from 4 hours to 21 days after onset
(4) CSF findings of inflammation (pleocytosis, elevated IgG index) OR gadolinium-enhancing cord lesion seen on MRI
Clinical findings may include:
(1) sensory deficit
(2) motor deficit
(3) autonomic dysfunction
where:
• If the CSF or MRI changes are absent at symptom onset, then presence on repeat analysis 2 to 7 days after symptom onset meets the criteria.
• If the patient awakens with symptoms then symptoms must become more pronounced after the waking.
Once the diagnosis of transverse myelitis has been made, then an investigation for a possible explanation should be started.
