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Acute transverse myelitis in COVID-19 infection

Chian Chiang Nicholas Chow, John Magnussen, Jerome Ip, Yuen Su

2020BMJ Case Reports108 citationsDOIOpen Access PDF

Abstract

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.

Topics & Concepts

MedicineHyperreflexiaWeaknessErythrocyte sedimentation rateUrinary retentionTransverse myelitisLumbar punctureAcute Transverse MyelitisWhite blood cellMyelitisComplicationNeurological examinationSerologySpinal cordCerebrospinal fluidAnesthesiaInternal medicineSurgeryImmunologyAntibodyPsychiatryLong-Term Effects of COVID-19Peripheral Neuropathies and DisordersInfectious Encephalopathies and Encephalitis
Acute transverse myelitis in COVID-19 infection | Litcius