Objectives: Neurologic manifestations of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2, COVID-19) infection are common and varied. The objective of this report was to describe clinicopathologic findings of rare acute ascending necrotizing myelitis (ANM) and briefly summarize similar COVID-19-associated longitudinally extended transverse myelitis cases. Methods: We described the clinical presentation, disease course, diagnostic workup, therapeutic measures, and pathologic findings of ANM associated with COVID-19 infection. Results: A 31-year-old previously healthy woman developed a longitudinally extensive lower thoracic myelopathy 3 weeks after COVID-19 infection. The thoracic spinal cord lesion extended to cervical level in 1 week and to the lower medullary level in 2 more weeks. Thoracic laminectomy at T5-T6 level and cord biopsy revealed necrobiotic changes without viral particles or microglial nodules. The clinical deficit stabilized after immunomodulatory and eculizumab therapies. Discussion: COVID-19 infection can cause ANM. It adds to the spectrum of reported cases of COVID-19 -associated encephalitis and myelitis.
Objectives: Neurologic manifestations of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2, COVID-19) infection are common and varied. The objective of this report was to describe clinicopathologic findings of rare acute ascending necrotizing myelitis (ANM) and briefly summarize similar COVID-19-associated longitudinally extended transverse myelitis cases. Methods: We described the clinical presentation, disease course, diagnostic workup, therapeutic measures, and pathologic findings of ANM associated with COVID-19 infection. Results: A 31-year-old previously healthy woman developed a longitudinally extensive lower thoracic myelopathy 3 weeks after COVID-19 infection. The thoracic spinal cord lesion extended to cervical level in 1 week and to the lower medullary level in 2 more weeks. Thoracic laminectomy at T5-T6 level and cord biopsy revealed necrobiotic changes without viral particles or microglial nodules. The clinical deficit stabilized after immunomodulatory and eculizumab therapies. Discussion: COVID-19 infection can cause ANM. It adds to the spectrum of reported cases of COVID-19 -associated encephalitis and myelitis.
Authors: Ross W Paterson; Rachel L Brown; Laura Benjamin; Ross Nortley; Sarah Wiethoff; Tehmina Bharucha; Dipa L Jayaseelan; Guru Kumar; Rhian E Raftopoulos; Laura Zambreanu; Vinojini Vivekanandam; Anthony Khoo; Ruth Geraldes; Krishna Chinthapalli; Elena Boyd; Hatice Tuzlali; Gary Price; Gerry Christofi; Jasper Morrow; Patricia McNamara; Benjamin McLoughlin; Soon Tjin Lim; Puja R Mehta; Viva Levee; Stephen Keddie; Wisdom Yong; S Anand Trip; Alexander J M Foulkes; Gary Hotton; Thomas D Miller; Alex D Everitt; Christopher Carswell; Nicholas W S Davies; Michael Yoong; David Attwell; Jemeen Sreedharan; Eli Silber; Jonathan M Schott; Arvind Chandratheva; Richard J Perry; Robert Simister; Anna Checkley; Nicky Longley; Simon F Farmer; Francesco Carletti; Catherine Houlihan; Maria Thom; Michael P Lunn; Jennifer Spillane; Robin Howard; Angela Vincent; David J Werring; Chandrashekar Hoskote; Hans Rolf Jäger; Hadi Manji; Michael S Zandi Journal: Brain Date: 2020-10-01 Impact factor: 13.501