Rashid hospital
neurology department

Author Of 1 Presentation

COVID-19 Late Breaking Abstracts

LB1230 - Longitudinally Extensive Transverse Myelitis in association with COVID-19 (ID 2109)

Speakers
Presentation Number
LB1230
Presentation Topic
COVID-19

Abstract

Background

Background: Since the beginning of Coronavirus disease 2019 (COVID-19) pandemic, several neurological associations have been described in literature including Transverse Myelitis. Longitudinally Extensive Transverse Myelitis (LETM) is largely known in association with Neuromyelitis Optica Spectrum Disorders (NMOSD) but can be seen with many other inflammatory, infectious, malignant and metabolic causes.

Objectives

Objectives: We hereby report our experience with 3 patients who suffered from LETM preceded by COVID-19 infection. The clinical presentation and outcome as well as the laboratory data is being discussed.

Methods

Methods: We collected the data from 3 patients who were diagnosed to have COVID-related LETM between the period from March 2020 to July 2020. We describe the clinical and laboratory data of these patienst in detail.

Results

Results: There were 3 patients seen from March 2020 to July 2020 who suffered from COVID-19 related post-infectious LETM. They were males from different backgrounds with age ranging from 32 to 52 years. Two of them presented with sensory symptoms and unstable gait, other presented with pure motor syndrome. We investigated the patients for other possible infectious/autoimmune etiologies in detail. All had positive COVID-19 PCR and developed myelitis-related symptoms in variable phase of post-infective period, ranging from 4 days to 4 weeks. NMO- antibodies were absent in all. Associated lab investigations revealed positive Lupus anticoagulant and low Protein S in one patent who developed myelitis within first week of infection and subsequently developed pulmonary embolism. Two patients had CSF results which showed slight increments in protein and leukocytes. Magnetic Resonance Imaging results long segment involvement of cervical and dorsal at different levels, with variable contrast enhancement. One had concomitant involvement of brain. They were all treated as acute post-infectious myelitis as per the general consensus with IV pulse steroid therapy, Methylprednisolone 1 gm daily for 5 days. All showed remarkable recovery and were discharged with minimal neurological symptoms, if at all.

Conclusions

Our findings suggest that despite being a potential cause of longitudinally extensive transverse myelitis, COVID-19 carries a good prognosis if treated in time, with pulse steroid therapy as in our case.

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