scholarly journals Acute Flaccid Myelitis in COVID-19

2020 ◽  
Vol 6 (3) ◽  
pp. 20200098
Author(s):  
Mohamed Abdelhady ◽  
Ahmed Elsotouhy ◽  
Surjith Vattoth
Keyword(s):  
Spinal Cord ◽  
Central Nervous System ◽  
Case Reports ◽  
Transverse Myelitis ◽  
Acute Disseminated Encephalomyelitis ◽  
Imaging Findings ◽  
Metabolic Complications ◽  
Acute Flaccid Myelitis ◽  
Post Infectious ◽  
Spinal Cord Imaging

Spinal cord imaging findings in COVID-19 are evolving with the increasing frequency of neurological symptoms among COVID-19 patients. Several mechanisms are postulated to be the cause of central nervous system affection including direct virus neuroinvasive potential, post infectious secondary immunogenic hyperreaction, hypercoagulability, sepsis and possible vasculitis as well as systemic and metabolic complications associated with critical illness. Only a few case reports of spinal cord imaging findings are described in COVID-19, which include transverse myelitis, acute disseminated encephalomyelitis and post-infectious Guillain Barre’ syndrome. We are describing a case of myelitis which, to the best of our knowledge, is the first reported case of myelitis in COVID-19.

scholarly journals Spectrum of spinal cord involvement in COVID-19: A systematic review

2020 ◽  
Author(s):  
Ritwick Mondal ◽  
Shramana Deb ◽  
Gourav Shome ◽  
Upasana Ganguly ◽  
Durjoy Lahiri ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Clinical Laboratory ◽  
Case Reports ◽  
Transverse Myelitis ◽  
Systemic Review ◽  
Cochrane Library ◽  
Imaging Data ◽  
Spinal Cord Involvement ◽  
Imaging Characteristics ◽  
Post Infectious

Background and aims- Recent reports reveal incidences of spinal cord involvement in form of para-infectious or post-infectious myelitis raising potential concerns about the possibilities of SARS-CoV-2 behind the pathogenesis of spinal cord demyelination. In this study, we intend to summarise so far available pieces of evidence documenting SARS-CoV-2 mediated spinal demyelination in terms of clinical, laboratory parameters and imaging characteristics. Methodology- This review was carried out based on the existing PRISMA (Preferred Report for Systemic Review and Meta-analyses) consensus statement. Data was collected from four databases: Pubmed/Medline, NIH Litcovid, Embase and Cochrane library and Preprint servers up till 10th September, 2020. Search strategy comprised of a range of keywords from relevant medical subject headings which includes "SARS-COV-2", "COVID-19", "demyelination" etc. Results- A total of 21 cases were included from 21 case reports after screening from various databases and preprint servers. Biochemical analysis reveals that the majority of cases showed elevated CSF protein as well as lymphocytic pleocytosis. Interestingly, a majority of cases were found to be associated with long extensive transverse myelitis (LETM), and remaining cases were found to be associated with isolated patchy involvement or isolated short segment involvement or combined LETM and patchy involvement. Few cases were also found with significant co-involvement of the brain and spine based on the imaging data. Conclusion- It can be interpreted that SARS-CoV-2 may play a potential role in spinal demyelinating disorders in both para-infectious and post-infectious forms.

First Presentation of an Acquired Demyelinating Syndrome

2017 ◽  
Vol 16 (03) ◽  
pp. 164-170
Author(s):  
Rachel Gottlieb-Smith ◽  
Amy Waldman
Keyword(s):  
Multiple Sclerosis ◽  
Central Nervous System ◽  
Nervous System ◽  
Differential Diagnosis ◽  
Optic Neuritis ◽  
Clinical Features ◽  
Neuromyelitis Optica ◽  
Transverse Myelitis ◽  
Acute Disseminated Encephalomyelitis ◽  
The Central Nervous System

AbstractAcquired demyelinating syndromes (ADS) present with acute or subacute monofocal or polyfocal neurologic deficits localizing to the central nervous system. The clinical features of distinct ADS have been carefully characterized including optic neuritis, transverse myelitis, and acute disseminated encephalomyelitis. These disorders may all be monophasic disorders. Alternatively, optic neuritis, partial transverse myelitis, and acute disseminated encephalomyelitis may be first presentations of a relapsing or polyphasic neuroinflammatory disorder, such as multiple sclerosis or neuromyelitis optica. The clinical features of these disorders and the differential diagnosis are discussed in this article.

scholarly journals Vaccine Induced Acute Transverse Myelitis: A Case Report

2016 ◽  
Vol 13 (2) ◽  
pp. 89-91 ◽  
Author(s):  
Avinash Chandra ◽  
Reema Rajbhandari ◽  
Samir Acharya ◽  
Priya Gurung ◽  
Basant Pant
Keyword(s):  
Multiple Sclerosis ◽  
Spinal Cord ◽  
Adverse Reactions ◽  
Transverse Myelitis ◽  
Active Immunization ◽  
Acute Transverse Myelitis ◽  
Autoimmune Phenomenon ◽  
Improve Accuracy ◽  
Post Traumatic ◽  
Post Infectious

Acute transverse myelitis is a focal infl ammatory disorder of the spinal cord. One of the main etiologic factors include, multiple sclerosis, post-infectious and post-traumatic events although autoimmune phenomenon is the most common cause. Transverse Myelitis (TM) due to etiology other than Multiple Sclerosis has shown spinal cord involvement of two or more segments. Annually millions of active immunization with vaccines is carried out globally with few transverse myelitis caused because of the adverse reactions due to these vaccinations. In order to improve accuracy of reporting, research and diagnosis, the Transverse Myelitis Consortium Working Group (TMCWG) have produced criteria for the diagnosis of ATM. Here we report a case of TM in adult, diagnosed as TM consistent with the TMCWG criteria and probably this is the first ever been reported case from Nepal. Nepal Journal of Neuroscience. Vol. 13, No. 2, 2016, Page: 89-91 

Neuromyelitis Optica

2017 ◽  
Author(s):  
Teri L. Schreiner ◽  
Jeffrey L. Bennett
Keyword(s):  
Multiple Sclerosis ◽  
Spinal Cord ◽  
Central Nervous System ◽  
Nervous System ◽  
Optic Neuritis ◽  
Neuromyelitis Optica ◽  
Water Channel ◽  
Transverse Myelitis ◽  
Inflammatory Disorder ◽  
The Central Nervous System

Neuromyelitis optica (NMO), or Devic’s disease is an inflammatory disorder of the central nervous system that preferentially affects the optic nerves and spinal cord. Initially considered a variant of multiple sclerosis (MS), NMO is now clearly recognized to have distinct clinical, radiographic, and pathologic characteristics. Historically, the diagnosis of NMO required bilateral optic neuritis and transverse myelitis; however, the identification of a specific biomarker, NMO-IgG, an autoantibody against the aquaporin-4 (AQP4) water channel, has broadened NMO spectrum disease to include patients with diverse clinical and radiographic presentations. This chapter addresses the diagnosis, pathophysiology, and management of the disease.

Acute Disseminated Encephalomyelitis

2017 ◽  
Author(s):  
Benjamin M. Greenberg ◽  
Allen Desena
Keyword(s):  
Spinal Cord ◽  
Central Nervous System ◽  
Nervous System ◽  
Supportive Care ◽  
Acute Disseminated Encephalomyelitis ◽  
Autoimmune Response ◽  
Inflammatory Disorder ◽  
The Central Nervous System ◽  
The Brain

Acute disseminated encephalomyelitis (ADEM) is a rare inflammatory disorder of the central nervous system (CNS) that can be fatal or lead to long-term disability. Various triggers have been identified in children and adults, which presumably cause an autoimmune response targeting myelin. The resulting inflammation causes demyelination and edema of the brain, spinal cord, and optic nerves. Depending on which portion of the CNS is affected, patients will experience a variety of symptoms including weakness, numbness, ataxia, encephalopathy, and seizures. Treatment is currently focused on reducing the amount of inflammation and supportive care.

scholarly journals Neuropsychiatric Manifestations of Scrub Typhus

2017 ◽  
Vol 08 (03) ◽  
pp. 421-426 ◽  
Author(s):  
Sanjay K. Mahajan ◽  
Sanyam K. Mahajan
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Clinical Picture ◽  
Scrub Typhus ◽  
Case Reports ◽  
Transverse Myelitis ◽  
Neurological Manifestations ◽  
Orientia Tsutsugamushi ◽  
Cranial Nerve Palsies ◽  
Neuropsychiatric Manifestations

ABSTRACTScrub typhus is caused by Orientia tsutsugamushi characterized by focal or disseminated vasculitis and perivasculitis which may involve the lungs, heart, liver, spleen and central nervous system. It was thought to have been eradicated from India. Recently it is being reported from many areas of India. The clinical picture and severity of the symptoms varies widely. The neurological manifestations of scrub typhus are not uncommon but are diverse. Meningoencephalitis is classical manifestation of scrub typhus but cerebellitis, cranial nerve palsies, plexopathy, transverse myelitis, neuroleptic malignant syndrome and Guillan-Barré syndrome are other manifestations reported in literature. The availability of literature on the neurological manifestations of scrub typhus is limited to case reports mainly. This article reviews various neurological manifestations of scrub typhus reported in literature.

Acute Flaccid Myelitis: A Clinical Review

2020 ◽  
Vol 40 (02) ◽  
pp. 211-218
Author(s):  
Olwen C. Murphy ◽  
Carlos A. Pardo
Keyword(s):  
Spinal Cord ◽  
Acute Flaccid Paralysis ◽  
Clinical Manifestations ◽  
Transverse Myelitis ◽  
The United States ◽  
Acute Onset ◽  
Flaccid Paralysis ◽  
Limb Weakness ◽  
Acute Flaccid Myelitis ◽  
Enterovirus D68

AbstractAcute flaccid myelitis (AFM) is an emerging disorder primarily affecting children that is characterized by acute flaccid paralysis accompanied by abnormalities of the spinal cord gray matter on magnetic resonance imaging. In most cases, prodromal fever or respiratory symptoms occur, followed by acute-onset flaccid limb weakness. Respiratory, axial, bulbar, facial, and extraocular muscles may also be affected. The clinical manifestations have been described as “polio-like,” due to striking similarities to cases of poliomyelitis. The primary site of injury in AFM is the anterior horn cells of the spinal cord, resulting in a motor neuronopathy. Seasonal peaks of cases have occurred in the United States every 2 years since 2012. However, AFM remains a rare disease, which can make it challenging for physicians to recognize and differentiate from other causes of acute flaccid paralysis such as Guillain–Barre syndrome, spinal cord stroke, and transverse myelitis. Epidemiological evidence suggests that AFM is linked to a viral etiology, with nonpolio enteroviruses (in particular enterovirus D68) demonstrating a plausible association. The epidemiology, possible etiological factors, clinical features, differential diagnosis, treatment, and outcomes of AFM are discussed in this review.

scholarly journals Post-infectious encephalomyelitis in an orthopedic surgeon with motor and cognitive impairment following Campylobacter gastroenteritis with complete recovery

2018 ◽  
Vol 6 (23) ◽  
pp. 22-27
Author(s):  
Christopher Crist ◽  
Nattamol Hosiriluck ◽  
Richard Winn
Keyword(s):  
Central Nervous System ◽  
Campylobacter Jejuni ◽  
Autoimmune Encephalitis ◽  
Complete Recovery ◽  
Acute Disseminated Encephalomyelitis ◽  
Autoimmune Response ◽  
Motor Deficits ◽  
Orthopedic Surgeon ◽  
Demyelinating Disorder ◽  
Post Infectious

Acute disseminated encephalomyelitis, also known as post-infectious encephalomyelitis, is an acute central nervous system demyelinating disorder which typically follows an autoimmune response secondary to a post-viral infection/syndrome. Although uncommon, the outcome can be devastating; mortality is not high but the morbidity may be catastrophic. Survival is anticipated but return to full function of highly motor skilled and cognitive individuals may not be expected. An orthopedic surgeon developed an acute autoimmune encephalitis presumed to be due to Campylobacter jejuni and despite initial significant cognitive and motor deficits was able to recover fully and ultimately return to his specialty surgical occupation.

scholarly journals 3-Tesla Study of the Spinal Cord White Matter

2009 ◽  
Vol 22 (1_suppl) ◽  
pp. 85-93
Author(s):  
L. Albini Riccioli ◽  
A.F. Marliani ◽  
M. Leonardi
Keyword(s):  
Spinal Cord ◽  
White Matter ◽  
High Field ◽  
Transverse Myelitis ◽  
Acute Disseminated Encephalomyelitis ◽  
Inhomogeneous Magnetic Field ◽  
Demyelinating Diseases ◽  
High Field Strength ◽  
Anatomical Area ◽  
3T Mr

Spinal cord as soon as brain, can be affected by dysmyelinating and demyelinating diseases, as Multiple Sclerosis (MS), Acute Disseminated Encephalomyelitis (ADEM), Neuromyelis Optica (NMO) and Transverse Myelitis. Investigation of the spinal cord with a high field strength MR system is hampered by the inhomogeneous magnetic field, physiological movements and the small size of the anatomical area. We describe normal and pathological neuroradiological findings in spinal cord white matter and the parameters of optimized sequences for use with the 3T MR systems.

Inflammatory disorders of the central nervous system

2016 ◽  
Author(s):  
Sathiji Nageshwaran ◽  
Heather C Wilson ◽  
Anthony Dickenson ◽  
David Ledingham
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Lupus Erythematosus ◽  
Transverse Myelitis ◽  
Acute Disseminated Encephalomyelitis ◽  
Evidence Based Treatment ◽  
System P ◽  
Primary Angiitis ◽  
Autoimmune Limbic Encephalitis ◽  
The Central Nervous System

Primary neuroinflammatory disorders of the central nervous system (multiple sclerosis, neuromyelitis optica (NMO), transverse myelitis, optic neuritis, acute disseminated encephalomyelitis (ADEM), primary angiitis of the central nervous system, autoimmune limbic encephalitis, and Susac’s syndrome) and multisystem diseases with inflammatory involvement of the central nervous system (sarcoidosis, systemic lupus erythematosus (SLE), giant cell arteritis, Behçet’s disease, Sjögren’s, and other vasculitides) are discussed in depth, covering the aetiology, clinical features and evidence-based treatment.

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