scholarly journals Conus myelitis associated with Covid 19 infection – a rare complication

2022 ◽  
pp. 259
Author(s):  
Keyword(s):  
Rare Complication ◽  
Neurological Complication ◽  
Transverse Myelitis ◽  
Respiratory Illness ◽  
Conus Medullaris ◽  
Nasopharyngeal Swab ◽  
High Dose ◽  
High Grade Fever ◽  
Acute Transverse Myelitis ◽  
Pulmonary Manifestations

Covid 19 pandemic has taken away millions of lives. Our understanding of this disease, till to date, is not complete. This disease has a wide variety of neurological manifestations. Acute transverse myelitis is one such rare neurological complication of Covid 19. The exact etiology is not clear. Auto immunity might be one of the possible mechanisms. We report a case of 39-year-old lady, who had recent history of high-grade fever and cough. This was followed by weakness of both legs and in- ability to pass urine. SARS-CoV-2 (PCR) from nasopharyngeal swab was positive. She was found to have features of acute non compressive myelopathy. MRI brain and MRI cervical spine with contrast was normal. MRI dorso lumbar spine with contrast was suggestive of diffuse hyper intensity of conus medullaris with contrast enhancement suggestive of conus myelitis. CSF analysis ruled out infection and autoimmune causes. She was pulsed with high dose steroids. There was some transient improvement in symptoms. Learning points: 1) Physicians should not consider Covid as a respiratory illness only. It can present with a variety of extra pulmonary manifestations. 2) Acute transverse myelitis is a rare complication of Covid 19 infection. Timely recognition and treatment can prevent permanent neurological damage and residual disability. 3) Conus myelitis might not present with classic upper motor neuron signs. Any new onset bladder dysfunction in a setting of a recent covid infection should be taken seriously and requires urgent imaging of the spine.

scholarly journals COVID-19–associated acute transverse myelitis: a rare entity

2020 ◽  
Vol 13 (8) ◽  
pp. e238668 ◽  
Author(s):  
Uddalak Chakraborty ◽  
Atanu Chandra ◽  
Aritra Kumar Ray ◽  
Purbasha Biswas
Keyword(s):  
Transverse Myelitis ◽  
Respiratory Illness ◽  
Acute Onset ◽  
Sensory Level ◽  
Rt Pcr ◽  
High Grade Fever ◽  
Acute Transverse Myelitis ◽  
Oropharyngeal Swab ◽  
Polymerase Chain ◽  
Compressive Myelopathy

SARS-CoV-2 has wreaked havoc globally and has claimed innumerable lives all over the world. Apart from the characteristic respiratory illness, this disease has been associated with florid extrapulmonary manifestations and complications. A 59-year-old female healthcare worker presented with features of acute-onset non-compressive myelopathy with a sensory level at T10 segment along with high-grade fever for 4 days. MRI of dorsal spine was suggestive of myelitis at T7 vertebral level. She was initiated on injectable steroids and did show some initial signs of recovery. A day later, she developed an acute-onset respiratory failure but could not be revived despite our best efforts. Her nasopharyngeal and oropharyngeal swab turned out to be positive for SARS-CoV-2 reverse transcriptase polymerase chain reaction (RT-PCR). We hereby report a case of acute transverse myelitis with COVID-19 as a probable aetiology.

scholarly journals Secondary Scoliosis as a Complication of Acute Transverse Myelitis in a Child

2020 ◽  
Vol 5 (2) ◽  
pp. 39
Author(s):  
Silvia D’Amico ◽  
Piero Pavone ◽  
Gianluca Testa ◽  
Filippo Greco ◽  
Lidia Marino ◽  
...  
Keyword(s):  
Transverse Myelitis ◽  
Complete Recovery ◽  
High Dose ◽  
Drug Induced ◽  
Rehabilitative Treatment ◽  
Immunomodulating Therapy ◽  
Acute Transverse Myelitis ◽  
Appropriate Treatment ◽  
Autoimmune Conditions ◽  
Thoracolumbar Curve

Acute transverse myelitis (ATM) is a rare neurological condition that affects the spinal cord. Several events, including infections, autoimmune conditions, inflammatory, and drug-induced factors, may cause this disorder. Correct and rapid etiological diagnosis is necessary in order to start appropriate treatment that mainly consists of immunomodulating therapy, high dose intravenous corticosteroids, and in plasma exchange in noninfectious cases. The outcome is varied and depends on several factors. In children, the prognosis is usually good. We report a case of an 11-year-old boy who presented with interscapular pain, right leg steppage, homolateral hyposthenia of the upper limb, and signs of autonomic dysfunction. After performing specific and instrumental exams, a diagnosis of transverse myelitis was reached, and appropriate therapy was performed. A few days post-treatment, the child developed a secondary scoliosis, involving a thoracolumbar curve with loss of cervical and lumbar lordosis. After rehabilitative treatment was undertaken for 12 months, a complete recovery and normal restoration of spinal physiological curves was obtained. The pediatric cases of ATM have a good response to steroid therapy combined with physiotherapy. Collaboration among the various specialists is worthwhile, in order to lead to a correct and rapid diagnosis.

scholarly journals Acute Transverse Myelitis at the Conus Medullaris Level After Rabies Vaccination in a Patient With Behcet's Disease

2007 ◽  
Vol 30 (3) ◽  
pp. 294-296 ◽  
Author(s):  
Levent Sinan Bir ◽  
Fatma Özdemir Eşmeli ◽  
Utku Cenikli ◽  
×ağdaş Erdoğan ◽  
Eylem Değirmenci
Keyword(s):  
Behçet’S Disease ◽  
Behcet’S Disease ◽  
Behçet's Disease ◽  
Transverse Myelitis ◽  
Conus Medullaris ◽  
Behcet's Disease ◽  
Acute Transverse Myelitis ◽  
Rabies Vaccination

Spinal anesthesia in a patient on monoclonal antibody treatment: a poisoned chalice? A case report

2021 ◽  
pp. rapm-2021-102557
Author(s):  
Anneleen Herijgers ◽  
Lisa Van Dyck ◽  
Ilse Leroy ◽  
Laurens Dobbels ◽  
Peter B C Van de Putte
Keyword(s):  
Monoclonal Antibody ◽  
Spinal Anesthesia ◽  
Rare Complication ◽  
Transverse Myelitis ◽  
Motor Deficit ◽  
Prior History ◽  
High Dose ◽  
Causative Role ◽  
Antibody Treatment ◽  
Monoclonal Antibody Treatment

BackgroundParaplegia is a rare complication of spinal anesthesia.Case presentationWe report a case of a 68-year-old man who developed postoperative paraplegia and hypoesthesia after spinal anesthesia for an otherwise uncomplicated transurethral resection of the prostate. Acute transverse myelitis was diagnosed based on urgent MRI. A prior history of similar though less severe neurological symptoms after obinutuzumab treatment for follicular lymphoma suggested a potential causative role for obinutuzumab, a novel monoclonal antibody that has not been associated with such devastating neurological side effects yet. High-dose steroid treatment partially attenuated the symptoms, but debilitating hypoesthesia and motor deficit remained present 3 months postoperatively.ConclusionThe presented case warrants caution when performing neuraxial anesthesia in patients on monoclonal antibody therapies.

Case of neuromyelitis optica: bilateral sensorineural hearing loss and transverse myelopathy following intrathecal chemotherapy

2020 ◽  
Vol 13 (4) ◽  
pp. e234076 ◽  
Author(s):  
Sergio A Castillo-Torres ◽  
Carlos A Soto-Rincón ◽  
Héctor J Villarreal-Montemayor ◽  
Beatriz Chávez-Luévanos
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Transverse Myelitis ◽  
Intrathecal Chemotherapy ◽  
Sensorineural Hearing ◽  
Intrathecal Methotrexate ◽  
High Dose ◽  
Chemotherapeutic Drugs ◽  
Acute Transverse Myelitis ◽  
Bilateral Sensorineural Hearing Loss

Neurotoxicity from intrathecally administered chemotherapeutic drugs is frequent, particularly with some agents like methotrexate, which are more prone to developing adverse effects. Myelopathy ranks among the most frequently reported neurological entities; with the diagnosis being straightforward, after ruling out infectious, metabolic, autoimmune or paraneoplastic causes. Scarcity of cases precludes evidence-based recommendations for the management of these complications. The most common therapeutic approach consists of the suspension of chemotherapy, exclusion of infectious and neoplastic causes, with prompt administration of high-dose steroids. We report a 21-year-old patient with acute lymphoblastic leukaemia, who developed acute transverse myelitis and bilateral sensorineural hearing loss, after five rounds of intrathecal methotrexate and cytarabine. Although neurotoxicity from both agents has been documented, this combination has not been previously reported.

Longitudinally Extensive Transverse Myelitis (LETM) and Myopericarditis in a 7-Month-Old Child with SARs-CoV-2 Infection

2021 ◽  
Author(s):  
Giacomo Brisca ◽  
Stefano Sotgiu ◽  
Daniela Pirlo ◽  
Barbara Tubino ◽  
Laura Siri ◽  
...  
Keyword(s):  
Cardiac Involvement ◽  
Transverse Myelitis ◽  
Acute Disseminated Encephalomyelitis ◽  
Neurological Complications ◽  
Nasopharyngeal Swab ◽  
High Dose ◽  
Longitudinally Extensive Transverse Myelitis ◽  
Permanent Disability ◽  
Longitudinal Extensive Transverse Myelitis ◽  
Extensive Transverse Myelitis

Abstract Introduction In the last few months, some pediatric cases with neurological and neuroradiological pictures related to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections have been reported, often associated with multisystem inflammatory syndrome (MIS-C). The most frequently encountered pediatric neurological complications seem to be postinfectious immune-mediated acute disseminated encephalomyelitis (ADEM)-like changes of the brain, myelitis, neural enhancement, and splenial lesions. Concomitant neurological and cardiac involvement has been reported only in MIS-C, although specific clinical details are often not fully available. Methods In this case report, a very young child infected with SARs-CoV-2 and diagnosed as longitudinal extensive transverse myelitis with concomitant myo-pericarditis is presented. Results A previously healthy 7-month-old girl presented with abrupt onset of generalized weakness with inability to sit up. She had had mild respiratory symptoms 1 week earlier. Spinal magnetic resonance imaging (MRI) showed a T2-hyperintense intramedullary lesion extending from C4 to T2, compatible with acute longitudinally extensive transverse myelitis (LETM). Cerebrospinal fluid analysis was negative.Echocardiography and blood tests were suggestive for myo-pericarditis. Real time polymerase chain reaction for SARS-CoV-2 on nasopharyngeal swab sample tested positive. She was promptly treated with high dose of steroids and immunoglobulin with satisfactory clinical response. Conclusion To the evolving literature of neurological complications of SARs-CoV-2 infection, we add the youngest patient described to date with isolated LETM and concomitant cardiac involvement. Our case suggests that clinicians should be aware of this association, although difficult to recognize in infants. Practitioners are encouraged to consider aggressive first-line immunotherapies with the final aim to prevent permanent disability.

Acute transverse myelitis: A rare neurological complication following wasp sting

2014 ◽  
Vol 62 (1) ◽  
pp. 88
Author(s):  
Kolar VishwanathVishwanath Vinod ◽  
Madasamy Ponraj ◽  
Khened Swetharani ◽  
TarunKumar Dutta
Keyword(s):  
Neurological Complication ◽  
Transverse Myelitis ◽  
Wasp Sting ◽  
Acute Transverse Myelitis

scholarly journals Longitudinal Extensive Transverse Myelitis in an Immunocompetent Older Individual—A Rare Complication of Varicella-Zoster Virus Reactivation

Medicina ◽  
2019 ◽  
Vol 55 (5) ◽  
pp. 201 ◽  
Author(s):  
Samar A. Abbas ◽  
Jeanine El Helou ◽  
Moussa A. Chalah ◽  
Hanine Hilal ◽  
Gaby Saliba ◽  
...  
Keyword(s):  
Varicella Zoster Virus ◽  
Rare Complication ◽  
Neurological Complication ◽  
Immunosuppressive Agents ◽  
Transverse Myelitis ◽  
Therapeutic Interventions ◽  
Immunocompromised Patients ◽  
Varicella Zoster ◽  
Longitudinal Extensive Transverse Myelitis ◽  
Extensive Transverse Myelitis

Varicella-zoster virus (VZV) is a human neurotropic herpes virus that causes chickenpox in children. After becoming latent in dorsal root ganglia, it can reactivate to cause dermatological manifestations, the most common one being shingles or herpes zoster. Severe neurologic dysfunctions can occur in immunocompromised patients such as encephalitis, meningitis, myelitis and neuropathy. Longitudinal extensive transverse myelitis (LETM) is an unusual neurological complication mainly described in immunocompromised patients, with very few cases described in immunocompetent ones. We hereby report a case of VZV-induced LETM in an immunocompetent older adult—a situation rarely described in the literature. LETM is a rare complication of VZV and its pathogenesis; therapeutic interventions and prognosis are far from being fully clarified. However, a prompt diagnosis is needed to allow a rapid initialization of treatment and ensure a better outcome. Although the therapeutic lines are not clear, immunosuppressive agents may have their place in cases of unsuccessful results and/or relapses following acyclovir coupled with a well conducted methylprednisolone therapy. Further studies are highly needed to improve the current understanding of the disease course and mechanisms, and to optimize therapeutic strategies.

scholarly journals Acute transverse myelitis in COVID-19 infection

2020 ◽  
Vol 13 (8) ◽  
pp. e236720 ◽  
Author(s):  
Chian Chiang Nicholas Chow ◽  
John Magnussen ◽  
Jerome Ip ◽  
Yuen Su
Keyword(s):  
Neurological Complication ◽  
Transverse Myelitis ◽  
Lower Limbs ◽  
Limb Weakness ◽  
Reactive Protein ◽  
Acute Transverse Myelitis ◽  
Elevated Protein ◽  
Normal Glucose ◽  
Bilateral Lower Limb ◽  
Whole Spine

A 60-year-old man presented to hospital with bilateral lower limb weakness, urinary retention and constipation. He had been diagnosed with COVID-19 10 days prior. Clinical examination revealed global weakness, increased tone, hyperreflexia and patchy paresthesia in his lower limbs bilaterally. Preliminary blood tests performed revealed a mildly elevated C reactive protein and erythrocyte sedimentation rate but was otherwise unremarkable. MRI scan of his whole spine demonstrated hyperintense T2 signal centrally from T7 to T10, suggestive of acute transverse myelitis. A lumbar puncture showed elevated protein count but normal glucose and white blood cell count. Serological testing for other viruses was negative. His neurological symptoms improved significantly after treatment with intravenous methylprednisone. This case highlights a potential neurological complication of COVID-19 infection.

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