scholarly journals Case Report: Acute Spinal Cord Myelopathy in Patients With COVID-19

2020 ◽  
Vol 11 ◽  
Author(s):  
Eman M. Khedr ◽  
Ahmed A. Karim ◽  
Radwa K. Soliman
Keyword(s):  
Spinal Cord ◽  
Elevated Serum ◽  
Transverse Myelitis ◽  
Artery Occlusion ◽  
Acute Onset ◽  
Nasopharyngeal Swab ◽  
University Hospitals ◽  
Thoracic Myelopathy ◽  
Mri Scan ◽  
Polymerase Chain

COVID-19 is typically associated with fever and severe respiratory symptoms including dry cough and dyspnea. However, COVID-19 may also affect both central and peripheral nervous systems. To date, the incidence rate of spinal cord involvement in COVID-19 is not known and the pathogenesis is still not fully understood. We report here two female patients admitted to Assiut University Hospitals/Egypt during the period from first of July to August 10, 2020. Both presented with a positive SARS-CoV-2 polymerase chain reaction (PCR) nasopharyngeal swab, elevated serum d-dimer and ferritin levels, and bilateral ground glass appearance in a CT chest scan. The first was a 60-year-old female with acute onset of flaccid paraplegia 10 days after flu-like symptoms, in whom MRI revealed transverse myelitis. The second was a 21-year-old female with symptoms of acute quadriplegia, fever, headache, and anosmia in whom an MRI scan revealed long cervico-thoracic myelopathy. Anterior spinal artery occlusion and possibly transverse myelitis were considered as differential diagnosis of long segment myelopathy.

Neuromyelitis optica spectrum disorder (NMOSD) presenting as acute transverse myelitis with positive aquaporin 4 antibodies

2021 ◽  
Vol 14 (1) ◽  
pp. e238992
Author(s):  
Katherine Thornley ◽  
Carlo Canepa
Keyword(s):  
Spinal Cord ◽  
Transverse Myelitis ◽  
Aquaporin 4 ◽  
Sensory Level ◽  
Mri Scan ◽  
Acute Transverse Myelitis ◽  
Longitudinal Extensive Transverse Myelitis ◽  
Oral Steroids ◽  
Extensive Transverse Myelitis

An 80-year-old, previously healthy patient presents with acute transverse myelitis with sensory level at T8. The MRI scan of the spinal cord showed longitudinal extensive transverse myelitis, and she tested positive for aquaporin 4 antibodies in serum. She received treatment with intravenous and oral steroids, with no improvement and then underwent plasma exchange. She was then started on azathioprine for prevention of relapses, while continuing physiotherapy and occupational therapy. Eventually, she was transferred to a specialised spinal cord centre for long-term rehabilitation.

scholarly journals Early-onset acute transverse myelitis following hepatitis B vaccination and respiratory infection: case report

2003 ◽  
Vol 61 (2A) ◽  
pp. 265-268 ◽  
Author(s):  
Luiz Fernando Fonseca ◽  
Thelma Ribeiro Noce ◽  
Maria Letícia Gambogi Teixeira ◽  
Antônio Lúcio Teixeira Jr ◽  
Marco Aurélio Lana-Peixoto
Keyword(s):  
Spinal Cord ◽  
Hepatitis B ◽  
Transverse Myelitis ◽  
Acute Onset ◽  
Clinical Syndrome ◽  
Hepatitis B Vaccination ◽  
Sensory Level ◽  
Resonance Imaging ◽  
Acute Transverse Myelitis ◽  
Viral Respiratory

Acute transverse myelitis is an acute inflammatory process of the spinal cord and it is a rare clinical syndrome in childhood. In this paper, we report a case of 3 years-old boy who developed acute onset tetraparesia following a viral respiratory infecction and hepatitis B vaccination. Magnetic resonance imaging of the spinal cord disclosed signal-intensity abnormalities from C4 to C3. A diagnosis of acute transverse myelitis was made and the patient was treated with IV methylprednisolone and IV immunoglobulin. The child had a fair outcome despite of the very acute course of the disease and the presence of a cervical sensory level which usually harbor a poor prognosis.

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 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 Longitudinally Extensive Transverse Myelitis (LETM) in COVID-19 Infection, A Case-Report

2021 ◽  
Author(s):  
Jean-Christophe Van Cutsem ◽  
Ann-Sophie Lamon ◽  
Vincent Van Belleghem ◽  
Evelien Vancaester
Keyword(s):  
Spinal Cord ◽  
Clinical Manifestations ◽  
Transverse Myelitis ◽  
Sudden Onset ◽  
Nasopharyngeal Swab ◽  
Sensory Level ◽  
Longitudinally Extensive Transverse Myelitis ◽  
Ataxic Gait ◽  
Normal Glucose Level ◽  
Extensive Transverse Myelitis

Abstract IntroductionSince the COVID-19 pandemic, a growing number of central nervous system (CNS) complications in patients with COVID-19 have been reported. Isolated, longitudinally extensive transverse myelitis (LETM), is a unique presentation of CNS involvement. The limited reports, its diverse clinical manifestations and the possible long-term consequences make the reporting crucial to further our understanding of those syndromes occurring in COVID-19 positive patients.Case PresentationA 63-year old male consulted the emergency department after a sudden onset of gait ataxia, a one-week history of paresthesia progressing from the feet to the midsternal area and urinary. He tested positive on a SARS-CoV-2 RNA RT-PCR nasopharyngeal swab two days prior to the onset of his symptoms. Neurological examination showed a sensory level at T7 with symmetrically reduced fine touch, vibration, proprioception and furthermore an ataxic gait was observed. Cerebrospinal fluid on day one of admission showed pleocytosis, predominantly neutrophils, elevated protein count and normal glucose level and IgG. MRI of the spinal cord revealed a diffusely increased signal intensity involving the near-complete spinal cord, from the brainstem to level T12, fitting the diagnosis of LETM. ConclusionThe few cases of transverse myelitis in association with COVID-infection are believed to have an immune-mediated postinfectious mechanism. In this case however, parainfectious direct viral invasion of the spinal cord is far more likely because of a neutrophilic predominance in CSF and a short timespan between infection and symptoms. It could provide more clues that the SARS-CoV-2 is acutally capable of causing direct neurotoxic effects.

scholarly journals Acute onset intramedullary spinal cord abscess with spinal artery occlusion: a case report and review

2011 ◽  
Vol 20 (S2) ◽  
pp. 294-301 ◽  
Author(s):  
Motoyuki Iwasaki ◽  
Shunsuke Yano ◽  
Takeshi Aoyama ◽  
Kazutoshi Hida ◽  
Yoshinobu Iwasaki
Keyword(s):  
Spinal Cord ◽  
Case Report ◽  
Artery Occlusion ◽  
Acute Onset ◽  
Intramedullary Spinal Cord ◽  
Intramedullary Spinal Cord Abscess

Acute Transverse Myelitis: A Retrospective Study Using Magnetic Resonance Imaging

1994 ◽  
Vol 21 (2) ◽  
pp. 133-136 ◽  
Author(s):  
Thomas Scott ◽  
Norbert Weikers ◽  
Mark Hospodar ◽  
Joseph Wapenski
Keyword(s):  
Magnetic Resonance Imaging ◽  
Spinal Cord ◽  
Retrospective Study ◽  
Magnetic Resonance ◽  
Transverse Myelitis ◽  
Acute Onset ◽  
Resonance Imaging ◽  
Diagnosis And Prognosis ◽  
Acute Transverse Myelitis ◽  
Magnetic Resonance Imaging Mri

Abstract:The prognostic value of magnetic resonance imaging (MRI) in the syndrome of acute transverse myelitis had not been evaluated. After retrospective study of 14 cases, we found that MRI is valuable for both diagnosis and prognosis in this illness. The criteria for the diagnosis of acute transverse myelitis consisted of acute onset (over less than 3 weeks) of symmetrical motor and sensory dysfunction referable to a distinct spinal cord level, with sphincter dysfunction. Patients with abnormal MRIs of the spinal cord had significantly worse outcomes than patients with normal MRIs.

An unusual case of spinal cord restricted mycobacteriosis in a European mink

2013 ◽  
Vol 41 (01) ◽  
pp. 63-66
Author(s):  
D. Schaudien ◽  
C. Flieshardt ◽  
I. Moser ◽  
H. Hotzel ◽  
A. Tipold ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Unusual Case ◽  
Histological Evaluation ◽  
Mustela Lutreola ◽  
Chain Reaction ◽  
European Mink ◽  
Pcr Product ◽  
Granulomatous Lesions ◽  
The Central Nervous System ◽  
Polymerase Chain

SummaryGranulomatous myelitis due to infection with Mycobacterium avium was diagnosed in a 4-year-old male neutered European mink (Mustela lutreola). The causative agent was detected by an acid-fast stain and further characterized by polymerase chain reaction and DNA sequencing of the PCR product. A thorough histological evaluation of the remaining organs revealed no granulomatous lesions or detectable acid-fast organisms. Although minks are generally highly susceptible for mycobacteria, localised infections, especially of the central nervous system, are unusual and may represent an atypical chronic form of the disease.

scholarly journals SARS-CoV-2 seroprevalence and asymptomatic viral carriage in healthcare workers: a cross-sectional study

Thorax ◽  
2020 ◽  
Vol 75 (12) ◽  
pp. 1089-1094 ◽  
Author(s):  
Adrian Shields ◽  
Sian E Faustini ◽  
Marisol Perez-Toledo ◽  
Sian Jossi ◽  
Erin Aldera ◽  
...  
Keyword(s):  
Intensive Care ◽  
Healthcare Workers ◽  
Venous Blood ◽  
Cross Sectional Study ◽  
Nasopharyngeal Swab ◽  
Sectional Study ◽  
University Hospitals ◽  
Cross Sectional ◽  
General Internal ◽  
Increased Risk

ObjectiveTo determine the rates of asymptomatic viral carriage and seroprevalence of SARS-CoV-2 antibodies in healthcare workers.DesignA cross-sectional study of asymptomatic healthcare workers undertaken on 24/25 April 2020.SettingUniversity Hospitals Birmingham NHS Foundation Trust (UHBFT), UK.Participants545 asymptomatic healthcare workers were recruited while at work. Participants were invited to participate via the UHBFT social media. Exclusion criteria included current symptoms consistent with COVID-19. No potential participants were excluded.InterventionParticipants volunteered a nasopharyngeal swab and a venous blood sample that were tested for SARS-CoV-2 RNA and anti-SARS-CoV-2 spike glycoprotein antibodies, respectively. Results were interpreted in the context of prior illnesses and the hospital departments in which participants worked.Main outcome measureProportion of participants demonstrating infection and positive SARS-CoV-2 serology.ResultsThe point prevalence of SARS-CoV-2 viral carriage was 2.4% (n=13/545). The overall seroprevalence of SARS-CoV-2 antibodies was 24.4% (n=126/516). Participants who reported prior symptomatic illness had higher seroprevalence (37.5% vs 17.1%, χ2=21.1034, p<0.0001) and quantitatively greater antibody responses than those who had remained asymptomatic. Seroprevalence was greatest among those working in housekeeping (34.5%), acute medicine (33.3%) and general internal medicine (30.3%), with lower rates observed in participants working in intensive care (14.8%). BAME (Black, Asian and minority ethnic) ethnicity was associated with a significantly increased risk of seropositivity (OR: 1.92, 95% CI 1.14 to 3.23, p=0.01). Working on the intensive care unit was associated with a significantly lower risk of seropositivity compared with working in other areas of the hospital (OR: 0.28, 95% CI 0.09 to 0.78, p=0.02).Conclusions and relevanceWe identify differences in the occupational risk of exposure to SARS-CoV-2 between hospital departments and confirm asymptomatic seroconversion occurs in healthcare workers. Further investigation of these observations is required to inform future infection control and occupational health practices.

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