Sara Sanghera Trivianne Franklin Veeranna Vibhuti Danielle Ford
HCA Healthcare
01-01-2025
Transverse myelitis (TM) is a rare inflammatory syndrome of the spinal cord that is often attributed to immune-mediated responses which lead to demyelination and the resultant varying degrees of motor..
Transverse myelitis (TM) is a rare inflammatory syndrome of the spinal cord that is often attributed to immune-mediated responses which lead to demyelination and the resultant varying degrees of motor, sensory, and autonomic dysfunction. While COVID-19 virus itself is known to present with anosmia, ageusia and Guillian Barre syndrome, a few rare cases of COVID-virus related TM have been reported. This case presents a 61-year-old female experiencing bilateral lower extremity weakness with brisk to absent reflexes. Onset of the symptoms was of 3 days origin, and she was tested positive for COVID-19. Patient did not have upper extremity symptoms but had new presentation of urine retention. MRI scan of C-spine showed extensive intramedullary cord lesion consistent with transverse myelitis with extensive demyelination extending to thoracic spine. Upon further workup from blood and CSF fluid studies, other viral or bacterial etiologies and autoimmune causes were ruled out. Patient was treated with IV glucocorticoids and a course of IVIG. After a few weeks course at a skilled rehab facility, she made partial but significant progress to the weakness. As more cases now continue to be reported, COVID-19 associated TM should be increasingly considered in the differential diagnosis. A greater understanding the mechanism behind COVID-19 related development of TM would allow for tailored management strategies, and in-turn better patient outcomes.