Para-Infectious Acute Transverse Myelitis Following Sars-Cov2 Infection: A Case Report

Abstract Introduction: The new pandemic has highlighted new ways of clinical presentation of severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) including a possible link to central nervous system (CNS) manifestation. Case report: We present a case of acute transverse myelitis following a SARS-CoV 2 infection in a 34-year-old man who presented with bilateral lower-extremity weakness and acute urinary retention. Cervical magnetic resonance imaging showed a T2 hyperintense signal abnormality at C3-C6 and D3-D7 levels consistent with acute myelitis. Conclusion: SARS-CoV 2 can cause myelitis by immune-mediated mechanisms, therefore it is extremely important for the clinicians to recognise the signs and promptly treat this neurological complication.

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Acute Transverse Myelitis Secondary to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2): A Case Report

Clinical Practice and Cases in Emergency Medicine ◽

10.5811/cpcem.2020.6.48462 ◽

2020 ◽

Vol 4 (3) ◽

pp. 344-348 ◽

Cited By ~ 1

Author(s):

Muhammad Durrani ◽

Kevin Kucharski ◽

Zachary Smith ◽

Stephanie Fien

Keyword(s):

Case Report ◽

Severe Acute Respiratory Syndrome ◽

Transverse Myelitis ◽

Neurological Complications ◽

Viral Pathogens ◽

Lower Extremity Weakness ◽

Thoracic Level ◽

Acute Transverse Myelitis ◽

Hyperintense Signal ◽

The Central Nervous System

Introduction: Respiratory viral illnesses are associated with diverse neurological complications, including acute transverse myelitis (ATM). Among the respiratory viral pathogens, the Coronaviridae family and its genera coronaviruses have been implicated as having neurotropic and neuroinvasive capabilities in human hosts.1 Despite previous strains of coronaviruses exhibiting neurotropic and neuroinvasive capabilities, little is known about the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its involvement with the central nervous system (CNS). The current pandemic has highlighted the diverse clinical presentation of SARS-CoV-2 including a possible link to CNS manifestation with disease processes such as Guillain-Barré syndrome and cerebrovascular disease. It is critical to shed light on the varied neurological manifestation of SARS-CoV-2 to ensure clinicians do not overlook at-risk patient populations and are able to provide targeted therapies appropriately. Case Report: While there are currently no published reports on post-infectious ATM secondary to SARS-CoV-2, there is one report of parainfectious ATM attributed to SARS-CoV-2 in pre-print. Here, we present a case of infectious ATM attributed to SARS-CoV-2 in a 24-year-old male who presented with bilateral lower-extremity weakness and overflow urinary incontinence after confirmed SARS-CoV-2 infection. Magnetic resonance imaging revealed non-enhancing T2-weighted hyperintense signal abnormalities spanning from the seventh through the twelfth thoracic level consistent with acute myelitis. Conclusion: The patient underwent further workup and treatment with intravenous corticosteroids with improvement of symptoms and a discharge diagnosis of ATM secondary to SARS-CoV-2.

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Clinical Approach to Pediatric Transverse Myelitis, Neuromyelitis Optica Spectrum Disorder and Acute Flaccid Myelitis

Children ◽

10.3390/children6050070 ◽

2019 ◽

Vol 6 (5) ◽

pp. 70 ◽

Cited By ~ 1

Author(s):

Cynthia Wang ◽

Benjamin Greenberg

Keyword(s):

Clinical Presentation ◽

Bladder Dysfunction ◽

Transverse Myelitis ◽

Bowel Dysfunction ◽

Spectrum Disorder ◽

Clinical Approach ◽

Acute Flaccid Myelitis ◽

Acute Transverse Myelitis ◽

Immune Mediated

Pediatric transverse myelitis (TM) is an acquired, immune-mediated disorder that leads to injury of the spinal cord and often manifests as weakness, numbness, bowel dysfunction, and/or bladder dysfunction. Multiple etiologies for myelitis can result in a similar clinical presentation, including idiopathic transverse myelitis (TM), multiple sclerosis (MS), neuromyeltis optica spectrum disorder (NMOSD) associated with anti-aquaporin 4 antibodies, MOG antibody-associated disease, and acute flaccid myelitis (AFM). Diagnosis relies on clinical recognition of the syndrome and confirming inflammation through imaging and/or laboratory studies. Acute treatment is targeted at decreasing immune-mediated injury, and chronic preventative therapy may be indicated if TM is determined to be a manifestation of a relapsing disorder (i.e., NMOSD). Timely recognition and treatment of acute transverse myelitis is essential, as it can be associated with significant morbidity and long-term disability.

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Acute Transverse Myelitis Associated with COVID-19 vaccine: A Case Report

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v12i3.4818 ◽

2021 ◽

Vol 12 (3) ◽

pp. 2083-2087

Author(s):

Ali Alshararni

Keyword(s):

Spinal Cord ◽

Case Report ◽

Acute Inflammation ◽

Transverse Myelitis ◽

Preventive Measure ◽

Mri Findings ◽

Dorsal Spinal Cord ◽

Lumbosacral Spinal Cord ◽

Acute Transverse Myelitis ◽

Magnetic Resonance Imaging Mri

The case report demonstrates the issue of Khalid Ali, who is a citizen of Yamen, explicitly living in Saudi Arabia. He is 38 years, weighs 82kgs, and of 162 cm in height. He is a sales professional and married with two kids. Khalid Ali has been living healthy until two years ago when he started experiencing pains in his lower extremities accompanied by numbness. He was treated, and everything went back to normal until soon when the case came back after the administration of the Pfizer vaccine as a preventive measure for COVID-19 disease. The consequence of the administration of the Pfizer vaccine resulted in severe pain and weaknesses in his legs and severe headache on the second day, which resulted in him being put on an ICU after 48 hours since he was almost paralyzed. A series of tests were conducted on him, including magnetic resonance imaging (MRI), hematology, and biochemistry which involved Cerebrospinal Fluid (CSF) protein test. MRI findings were significant since they indicated acute inflammation on the spine observed on the dorsal spinal cord with contrast and lumbosacral spinal cord. All the hematology tests turned out to be expected. Biochemistry conducted tests were similarly standard except for CSF protein which was highly abnormal. The combination of the high abnormal CSF protein test and acute inflammation of the spine observed from the MRI findings were confirmed evidence of acute transverse myelitis as a result of the administration of the Pfizer vaccine.

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Relevance of CSF, Serum and Neuroimaging Markers in CNS and PNS Manifestation in COVID-19: A Systematic Review of Case Report and Case Series

Brain Sciences ◽

10.3390/brainsci11101354 ◽

2021 ◽

Vol 11 (10) ◽

pp. 1354

Author(s):

Sanjiti Podury ◽

Samiksha Srivastava ◽

Erum Khan ◽

Mihir Kakara ◽

Medha Tandon ◽

...

Keyword(s):

Systematic Review ◽

Case Report ◽

Corpus Callosum ◽

Neurological Complication ◽

Case Series ◽

Transverse Myelitis ◽

Acute Disseminated Encephalomyelitis ◽

Neurological Manifestations ◽

Comprehensive Review ◽

Inflammatory Disorders

Background: The data on neurological manifestations in COVID-19 patients has been rapidly increasing throughout the pandemic. However, data on CNS and PNS inflammatory disorders in COVID-19 with respect to CSF, serum and neuroimaging markers is still lacking. Methods: We screened all articles resulting from a search of PubMed, Google Scholar and Scopus, using the keywords “SARS-CoV-2 and neurological complication”, “SARS-CoV-2 and CNS Complication” and “SARS-CoV-2 and PNS Complication” looking for transverse myelitis, vasculitis, acute disseminated encephalomyelitis, acute hemorrhagic necrotizing encephalitis (AHNE), cytotoxic lesion of the corpus callosum (CLOCC) and Guillain-Barré syndrome (GBS), published between 1 December 2019 to 15 July 2021. Results: Of the included 106 CNS manifestations in our study, CNS inflammatory disorders included transverse myelitis (17, 14.7%), AHNE (12, 10.4%), ADEM (11, 9.5%), CLOCC/MERS (10, 8.6%) and vasculitis (4, 3.4%). Others were nonspecific encephalopathy, encephalitis, seizures and stroke. Most patients were >50 years old (75, 70.8%) and male (64, 65.3%). Most (59, 63.4%) were severe cases of COVID-19 and 18 (18%) patients died. Of the included 94 PNS manifestations in our study, GBS (89, 92.7%) was the most common. Most of these patients were >50 years old (73, 77.7%) and male (59, 64.1%). Most (62, 67.4%) were non-severe cases of COVID-19, and ten patients died. Conclusion: Our comprehensive review of the clinical and paraclinical findings in CNS and PNS manifestations of COVID-19 provide insights on the pathophysiology of SARS-CoV-2 and its neurotropism. The higher frequency and severity of CNS manifestations should be noted by physicians for increased vigilance in particular COVID-19 cases.

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