A Case of Transverse Myelitis Secondary to COVID-19 Infection

Infection with COVID-19 (SARS-CoV-2) is associated with a variety of generalized and specific symptoms, including neurological complications of both the peripheral and central nervous system. In this case report, we present the case of a previously healthy 55-year-old woman who was diagnosed with transverse myelitis following a previous infection with COVID-19. Her initial presenting symptoms were numbness and tingling of the abdomen, neurogenic bladder, hyperreflexia of the bilateral lower extremities, positive Babinski sign, sensory decrement to pin prick below T5 dermatome, and generalized weakness over the previous 20 days with slow progression caudally into the bilateral lower extremities that resulted in difficulties ambulating. She had no symptoms of the upper extremities or face and denied ever previously experiencing similar symptoms. MRI showed progressive demyelination of the cervical, and thoracic spinal cord, cerebrospinal fluid (CSF) showed increased levels of protein and red blood cells and no markers of infection, including negative PCR for COVID-19 antibodies. The patient was treated with a course of methylprednisolone, multiple treatments of plasmapheresis, and ongoing treatment with rituximab, all of which were well-tolerated. She was instructed to follow-up with her primary care physician 5–7 days after hospital discharge.