Current Concepts in the Diagnosis of Transverse Myelopathies

Clin Neurol Neurosurg. 2008 Nov;110(9):919-27. doi: 10.1016/j.clineuro.2008.07.002. Epub 2008 Aug 20.


The clinical symptoms and MRI characteristics of transverse myelopathy (TM) due to non-compressive causes are reviewed, with special emphasis on the differential diagnosis between inflammatory demyelinating lesions, and metabolic and vascular myelopathies. Inflammatory transverse myelopathies are the commonest and most difficult ones to identify. The differentiation between clinically isolated syndromes, multiple sclerosis, neuromyelitis optica, acute disseminated encephalomyelitis and metabolic causes is based on both clinical symptoms and paraclinical signs including magnetic resonance imaging, cerebrospinal fluid analysis, and immunological and biochemical parameters. The most intriguing form of TM is that where there is clinical evidence of complete spinal cord transection, with normal findings in magnetic resonance imaging in the acute phase, but subsequent cord atrophy.

Publication types

  • Review

MeSH terms

  • Adult
  • Animals
  • Autoimmune Diseases / diagnosis
  • Autoimmune Diseases / pathology
  • Demyelinating Diseases / diagnosis
  • Demyelinating Diseases / pathology
  • Diagnosis, Differential
  • Humans
  • Magnetic Resonance Imaging
  • Myelitis, Transverse / diagnosis*
  • Myelitis, Transverse / pathology
  • Neuromyelitis Optica / diagnosis
  • Neuromyelitis Optica / pathology
  • Spinal Cord Diseases / metabolism