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An otherwise healthy 28-year-old woman presents with progressive weakness for the past 3 days, numbness below her breasts, and urinary urgency. Neck flexion triggers an electrical sensation that radiates to the coccyx. Examination reveals moderate paraparesis with hyperreflexia, a left extensor plantar response, impaired vibratory and proprioceptive sensation, and a sensory level at T6. Magnetic resonance imaging reveals a lower cervical cord lesion that enhances after gadolinium administration, a finding consistent with transverse myelitis. How should she be further evaluated and treated?
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Frohman et al. (2010) studied this question.
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