Acute transverse myelitis after inactivated COVID-19 vaccine

2021 ◽  
Vol 74 (7-8) ◽  
pp. 273-276
Author(s):  
Nazan Şimşek Erdem ◽  
Seden Demirci ◽  
Tuğba Özel ◽  
Khalida Mamadova ◽  
Kamil Karaali ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Life Sciences ◽  
Transverse Myelitis ◽  
Upper Extremities ◽  
Resonance Imaging ◽  
Longitudinally Extensive Transverse Myelitis ◽  
Acute Transverse Myelitis ◽  
Spinal Cord Segment ◽  
Extensive Transverse Myelitis ◽  
Spine Magnetic Resonance Imaging

Vaccines against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been rapidly developed to prevent coronavirus disease 2019 (COVID-19) pandemic. There is increasing safety concerns regarding COVID-19 vaccines. We report a 78-year old woman who was presented with tetraparesis, paresthesias of bilateral upper extremities, and urinary retention of one-day duration. Three weeks before these symptoms, she was vaccinated with CoronaVAC vaccine (Sinovac Life Sciences, China). Spine magnetic resonance imaging showed longitudinally extensive transverse myelitis (TM) from the C1 to the T3 spinal cord segment. An extensive diagnostic workup was performed to exclude other possible causes of TM. We suggest that longitudinally extensive TM may be associated with COVID-19 vaccination in this case. To the best of our knowledge, this is the first report of longitudinally extensive TM developing after CoronaVac vaccination. Clinicians should be aware of neurological symptoms after vaccination of COVID-19.

The differential diagnosis of longitudinally extensive transverse myelitis

2011 ◽  
Vol 18 (3) ◽  
pp. 271-285 ◽  
Author(s):  
JL Kitley ◽  
MI Leite ◽  
JS George ◽  
JA Palace
Keyword(s):  
Magnetic Resonance Imaging ◽  
Spinal Cord ◽  
Early Identification ◽  
Transverse Myelitis ◽  
Resonance Imaging ◽  
Longitudinally Extensive Transverse Myelitis ◽  
Spinal Magnetic Resonance Imaging ◽  
Appropriate Therapy ◽  
T2 Hyperintensity ◽  
Extensive Transverse Myelitis

Longitudinally extensive transverse myelitis refers to florid and widespread inflammation of the spinal cord causing T2 hyperintensity on spinal magnetic resonance imaging that is seen to extend over three or more vertebral segments. Whilst rare, longitudinally extensive transverse myelitis is clinically important as it can lead to catastrophic morbidity, and a group of these patients are at risk of further attacks. Early identification and establishment of the underlying aetiology is vital in order to initiate appropriate therapy and optimize outcomes. Whilst longitudinally extensive transverse myelitis is classically associated with neuromyelitis optica, there are many other causes. These include other inflammatory aetiologies, infection, malignancy and metabolic disturbance. Some of these are readily treatable. Laboratory and radiological investigations can help to differentiate these causes. Treatment of longitudinally extensive transverse myelitis hinges on distinguishing inflammatory and non-inflammatory aetiologies and identifying patients who are at high risk of a recurrent course.

scholarly journals Differentiating neuromyelitis optica from other causes of longitudinally extensive transverse myelitis on spinal magnetic resonance imaging

2015 ◽  
Vol 22 (3) ◽  
pp. 302-311 ◽  
Author(s):  
Yeliz Pekcevik ◽  
Charles H Mitchell ◽  
Maureen A Mealy ◽  
Gunes Orman ◽  
In H Lee ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Neuromyelitis Optica ◽  
Brain Mri ◽  
Transverse Myelitis ◽  
Resonance Imaging ◽  
Longitudinally Extensive Transverse Myelitis ◽  
Mri Findings ◽  
Spinal Magnetic Resonance Imaging ◽  
Extensive Transverse Myelitis

Background: Although spinal magnetic resonance imaging (MRI) findings of neuromyelitis optica (NMO) have been described, there is limited data available that help differentiate NMO from other causes of longitudinally extensive transverse myelitis (LETM). Objective: To investigate the spinal MRI findings of LETM that help differentiate NMO at the acute stage from multiple sclerosis (MS) and other causes of LETM. Methods: We enrolled 94 patients with LETM into our study. Bright spotty lesions (BSL), the lesion distribution and location were evaluated on axial T2-weighted images. Brainstem extension, cord expansion, T1 darkness and lesion enhancement were noted. We also reviewed the brain MRI of the patients during LETM. Results: Patients with NMO had a greater amount of BSL and T1 dark lesions ( p < 0.001 and 0.003, respectively). The lesions in NMO patients were more likely to involve greater than one-half of the spinal cord’s cross-sectional area; to enhance and be centrally-located, or both centrally- and peripherally-located in the cord. Of the 62 available brain MRIs, 14 of the 27 whom were NMO patients had findings that may be specific to NMO. Conclusions: Certain spinal cord MRI features are more commonly seen in NMO patients and so obtaining brain MRI during LETM may support diagnosis.

scholarly journals Acute Transverse Myelitis Following COVID-19 Vaccination

Vaccines ◽  
2021 ◽  
Vol 9 (9) ◽  
pp. 1008
Author(s):  
Jhih-Jian Gao ◽  
Hung-Pin Tseng ◽  
Chun-Liang Lin ◽  
Jr-Shiang Shiu ◽  
Ming-Hsun Lee ◽  
...  
Keyword(s):  
Rare Case ◽  
Vitamin B12 Deficiency ◽  
Transverse Myelitis ◽  
Genetically Engineered ◽  
Longitudinally Extensive Transverse Myelitis ◽  
Epidemic Disease ◽  
Angiotensin Converting Enzyme 2 ◽  
Acute Transverse Myelitis ◽  
B12 Deficiency ◽  
Extensive Transverse Myelitis

An increasing number of people are undergoing vaccination for COVID-19 because of the ongoing pandemic. The newly developed, genetically engineered mRNA vaccines are critical for controlling the epidemic disease. However, major adverse effects, including neuroimmunological disorders, are being attributed to this vaccine. For instance, several cases of acute transverse myelitis (ATM) after COVID-19 vaccination have been reported in clinical trials. Here, we report an exceedingly rare case of longitudinally extensive transverse myelitis (LETM), a rare subtype of ATM involving three or more vertebral segments, that occurred shortly after vaccination with the Moderna COVID-19 (mRNA-1273) vaccine, with a comorbidity of vitamin B12 deficiency. The findings of subsequent investigations suggest the possibility that autoimmune responses are triggered by the reactions between anti-SARS-CoV-2 spike protein antibodies and tissue proteins, as well as the interaction between spike proteins and angiotensin-converting enzyme 2 receptors.

Occurrence of acute large and edematous callosal lesions in neuromyelitis optica

2009 ◽  
Vol 15 (6) ◽  
pp. 695-700 ◽  
Author(s):  
M Nakamura ◽  
T Misu ◽  
K Fujihara ◽  
I Miyazawa ◽  
I Nakashima ◽  
...  
Keyword(s):  
Neuromyelitis Optica ◽  
Medical Records ◽  
Brain Magnetic Resonance Imaging ◽  
Transverse Myelitis ◽  
Resonance Imaging ◽  
Longitudinally Extensive Transverse Myelitis ◽  
Lower Margin ◽  
Chronic Stage ◽  
The Brain ◽  
Extensive Transverse Myelitis

Background The corpus callosum is commonly involved in multiple sclerosis (MS), but the characteristics of callosal lesions in neuromyelitis optica (NMO) are unknown. Objective To reveal the features of callosal lesions in NMO in comparison to MS. Methods We retrospectively reviewed the medical records and the brain magnetic resonance imaging films of 56 patients with MS and 22 patients with NMO. Results In MS, 36 (64.3%) of 56 patients had callosal lesions, but only four patients had acute lesions. All such acute lesions were small, isolated and non-edematous, and the intensity was homotonic. Chronic lesions were observed in 34 patients with MS, and 32 (94%) of them presented small lesions located at the callosal lower margin (“hemi-oval pattern”). Meanwhile, four (18.2%) patients with NMO had callosal lesions, and three of them had acute lesions. Those acute lesions were multiple, large edematous ones with heterogeneous intensity (“marbled pattern”). In the chronic stage, the lesions shrank or disappeared. Conclusions Acute large, edematous callosal lesions occasionally occur in NMO. Similar to longitudinally extensive transverse myelitis, such callosal lesions may reflect severe edematous inflammation in NMO, and may provide additional evidence that the pathogenesis in NMO is different from that in MS.

Prognostic Parameters of Acute Transverse Myelitis in Children

2020 ◽  
Vol 35 (14) ◽  
pp. 999-1003
Author(s):  
Esther Ganelin-Cohen ◽  
Osnat Konen ◽  
Yoram Nevo ◽  
Rony Cohen ◽  
Ayelet Halevy ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Disease Onset ◽  
Brain Magnetic Resonance Imaging ◽  
Transverse Myelitis ◽  
Common Finding ◽  
Imaging Features ◽  
Imaging Findings ◽  
Resonance Imaging ◽  
Acute Transverse Myelitis

Acute transverse myelitis is a rare and disabling disorder. Data on the imaging features in children are sparse. The aim of this study was to describe the clinical and magnetic resonance imaging findings characteristic of pediatric idiopathic acute transverse myelitis and to identify those with prognostic value. The database of a tertiary pediatric medical center was retrospectively reviewed for patients aged less than 18 years who were diagnosed in 2002-2017 with acute transverse myelitis that was not associated with recurrence of a demyelinating autoimmune event. Data were collected on clinical, laboratory, and imaging findings and outcome. A total of 23 children (11 male, 12 female) met the study criteria. Mean age at disease onset was 10 years, and mean duration of follow-up was 6 years 10 months. Spinal cord and brain magnetic resonance imaging scans were performed on admission or shortly thereafter. The most common finding was cross-sectional involvement, in 16 patients (70%). The mean number of involved spinal segments was 8. The most frequently involved region was the thoracic spine, in 17 patients (74%). Clinical factors predicting good prognosis were cerebrospinal fluid pleocytosis, absence of tetraparesis, and prolonged time to nadir. In conclusion, most children with acute transverse myelitis appear to have a good outcome. Prompt diagnosis and treatment are important. Further research is needed in a larger sample to evaluate the predictive value of imaging features.

Brain magnetic resonance imaging findings in acute relapses of neuromyelitis optica spectrum disorders

2007 ◽  
Vol 14 (2) ◽  
pp. 248-251 ◽  
Author(s):  
JA Cabrera-Gómez ◽  
A. Saiz-Hinarejos ◽  
F. Graus ◽  
A. González-Quevedo ◽  
R. Rodríguez-Rojas ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Neuromyelitis Optica ◽  
Brain Mri ◽  
Brain Magnetic Resonance Imaging ◽  
Transverse Myelitis ◽  
Resonance Imaging ◽  
Igg Antibody ◽  
Magnetic Resonance Imaging Mri ◽  
Extensive Transverse Myelitis

We studied cranial magnetic resonance imaging (MRI) lesions in three women with acute attacks of recurrent longitudinally extensive transverse myelitis (r-LETM), recurrent-optic neuritis (r-ON) and r-LETM-CNS. Neuromyelitis Optica -immunoglobulin (IgG) antibody was positive in all cases. Brain MRI (1.5 Tesla) was performed according to protocol from consortium MS centre. We described the cranial lesions in brain MRI of acute relapses. These lesions were different from MS, most had an asymptomatic course which disappeared with time, protocol from consortium of MS centre criteria for brain MRI and seropositivity of NMO-IgG are useful tools for differentiate acute lesions of NMO/MS. Multiple Sclerosis 2008; 14: 248—251. http://msj.sagepub.com

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