Abstract
Purpose of Review The purpose of this study was to evaluate demographics, clinical profiles, and outcomes of transverse myelitis (TM) in the setting of COVID-19 infection (iTM) or vaccination (vTM) and to describe a case of spontaneous resolution of iTM.
Recent Findings Of a total of 158 articles that met our search criteria, 30 articles detailing 65 unique cases were included, of which 48 (73.8%) were iTM and 17 (26.2%) were vTM. The mean age of the iTM group was significantly lower as compared with vTM (43 ± 20.3 years vs 56.4 ± 18.6 years; p = 0.02). There were no gender differences between the groups. There were no significant differences in time to symptom onset (9.9 ± 14.3 days in iTM vs 7.6 ± 7.0 days in vTM, p = 0.2) between the groups. There were no significant differences between iTM and vTM in imaging features or laboratory abnormalities. The most common pharmacotherapy that was administered was intravenous (i.v.) corticosteroid (n = 56, 87.5%), followed by oral corticosteroids (n = 20, 31.2%), plasmapheresis (n = 19, 29.7%), and intravenous immunoglobulin (n = 14, 21.9%). Most of the cases reported a good outcome (n = 51, 79.7%) with no significant differences between the groups (77.1% in iTM vs 87.5% in vTM; p = 0.37).
Summary There are no significant differences with respect to time to presentation, clinical and radiological features, and in outcomes between iTM and vTM, suggesting a common pathogenesis. Approximately 80% of cases have a good outcome. Hence, early recognition and treatment are important. Our case demonstrates that treatment should be based on the clinical presentation rather than laboratory or imaging features.
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.
↵* Both authors contributed equally to this work.
Submitted and externally peer reviewed. The handling editor was Deputy Editor Kathryn Kvam, MD.
COVID-19 Resources: NPub.org/COVID19
- Received June 10, 2022.
- Accepted August 24, 2022.
- © 2022 American Academy of Neurology
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