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.
Footnotes
Funding information and disclosures are provided at the end of the article. Full disclosure form information provided by the authors is available with the full text of this article at Neurology.org/cp.
↵* These authors contributed equally to this work.
Submitted and externally peer reviewed. The handling editor was Deputy Editor Kathryn Kvam, MD.
- Received January 6, 2022.
- Accepted April 12, 2022.
- © 2022 American Academy of Neurology
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