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Lynchburg Journal of Medical Science

Advisor

Thomas Colletti

Abstract

The objective of this paper is to review a case report for a patient with idiopathic transverse myelitis. This rare disease can easily be forgotten based on the vagueness of symptoms and as the presentation can vary drastically. In this case, a magnetic resonance imaging (MRI) test was ordered after a patient presented with a sensory deficit from the level of his chest to his toes that showed a 1.5 centimeter (cm) intramedullary spinal cord lesion at the level of T1. From the imaging, the differential diagnosis included transverse myelitis, a demyelinating lesion, and primary neoplasms such as ependymoma and astrocytoma. Further imaging, laboratory tests, and infusion of corticosteroids led to the diagnosis of idiopathic transverse myelitis as there was no other identifiable cause and the lesion shrunk after administration of corticosteroids. Unlike this case, myelopathies can involve motor aspects of sensation that can significantly impair quality of life and increase the urgency for diagnosis and resolution of symptoms, which is why early identification of this diagnosis and the etiology is critical.

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