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Neurol Clin Pract . Acute Ascending Necrotizing Myelitis After COVID-19 Infection: A Clinicopathologic Report

tetano

Editor, Senior Moderator
Neurol Clin Pract


. 2022 Jun;12(3):e28-e32.
doi: 10.1212/CPJ.0000000000001175.
Acute Ascending Necrotizing Myelitis After COVID-19 Infection: A Clinicopathologic Report


Luis Guada[SUP] 1 [/SUP], Franklyn Rocha Cabrero[SUP] 1 [/SUP], Nicole L Baldwin[SUP] 1 [/SUP], Allan D Levi[SUP] 1 [/SUP], Sakir H Gultekin[SUP] 1 [/SUP], Ashok Verma[SUP] 1 [/SUP]



Affiliations

Abstract

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.
 
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