Diagnosis of TM is made following history, physical examination, magnetic resonance imaging (MRI) spinal cord and brain, and cerebrospinal fluid (CSF) analysis. Other possible causes of symptoms, such as spinal cord compression and ischaemia, require exclusion. Additional tests are based on the MRI and CSF test results and aim to identify whether the spinal cord syndrome is due to an inflammatory disorder, infection, or paraneoplastic aetiology, and to pinpoint its cause. They include testing for antibodies against aquaporin-4 (AQP4) and myelin oligodendrocyte glycoprotein (MOG), special CSF stains, cultures and tests for infections, chest x-ray, computed tomography (CT) of the thorax, viral serologies, auto-antibodies to test for systemic lupus erythematosus (SLE) or Sjogren's syndrome, visual evoked potential and/or optical coherence tomography, and biopsies.
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