COVID-19 Associated Longitudinal Extensive Transverse Myelitis with Cerebral Spinal Fluid SARS-CoV-2 Detection

Authors

  • Fábio Gomes Serviço de Neurologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal https://orcid.org/0000-0001-7121-4776
  • Cláudia Lima Instituto Português de Oncologia Francisco Gentil - Coimbra, Coimbra, Portugal
  • Cristina Valente Serviço de Doenças Infecciosas / Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
  • João Vaz Serviço de Patologia Clínica / Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
  • Lurdes Correia Serviço de Patologia Clínica / Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
  • Inês Correia Serviço de Neurologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal

DOI:

https://doi.org/10.46531/sinapse/CC/230058/2023

Keywords:

COVID-19, Myelitis, Transverse, RNA, Viral/cerebrospinal fluid, SARS-CoV-2

Abstract

There have been multiple reports of COVID-19 associated neurological symp-toms, including several cases of para-infectious myelitis.We report a case of an 84-year-old male patient presenting with acute paraparesis coinciding with active mild COVID-19 pneumonia. Spinal cord magnetic resonance imaging (MRI) showed longitudinally extensive transverse myelitis (LETM) affecting the entire cervical cord to the tenth thoracic level, and cerebral spinal fluid (CSF) was positive for SARS-CoV-2. The patient was evaluated for other causes of LETM, which were convincingly excluded. He was treated with steroid pulses and plasmapheresis, with significant imaging improvement. The patient has since made a good recovery, being now able to walk unassisted. Although several instances of COVID-19 associated myelitis have been reported, positive identification of the virus in CSF is rare. The identification of viral material may support the hypothesis of direct spinal cord infection in co-occurrence with a para-infectious inflammatory reaction.

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Published

2024-01-27

How to Cite

1.
Gomes F, Lima C, Valente C, Vaz J, Correia L, Correia I. COVID-19 Associated Longitudinal Extensive Transverse Myelitis with Cerebral Spinal Fluid SARS-CoV-2 Detection. Sinapse [Internet]. 2024 Jan. 27 [cited 2024 Apr. 16];23(4):212-6. Available from: https://sinapse.pt/index.php/journal/article/view/6

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