Mathew Ezek, Williamson Julie, Mamo Lois, Dickerman Rob
1University of North Texas Health Science Center, Fort Worth, Texas; and.
2Department of Neurosurgery, The Medical City of Frisco, Frisco, Texas.
J Neurosurg Case Lessons. 2022 Dec 12;4(24). doi: 10.3171/CASE22244.
Transverse myelitis is a rare neurological occurrence with varied presentation. Imaging is necessary to properly diagnose this condition; however, identifying the cause of this condition may often be difficult.
An otherwise healthy patient presented to the clinic with peculiar neurological symptoms without an obvious underlying cause. Imaging evidenced no significant structural defects but did lead to discovery of cord enhancement compatible with a diagnosis of transverse myelitis. Corticosteroid treatment was initiated rapidly to address this pathology, and the patient recovered without deficits. To identify the underlying cause, patient medical history was reviewed thoroughly and compared with existing literature. Previous tuberculosis infection could be a less likely cause of the neurological symptoms. However, recent vaccination with the Johnson & Johnson coronavirus disease 2019 (COVID-19) vaccine could be a more likely cause of the transverse myelitis, which has been rarely reported.
Transverse myelitis after COVID-19 infection has been an escalating phenomenon. However, transverse myelitis after COVID-19 vaccination is a rare occurrence that is also on the rise. Given the increased rates of vaccination, transverse myelitis should not be overlooked as a potential pathology, due to the severity of neurological impairment if this condition is not treated rapidly.
横贯性脊髓炎是一种罕见的神经系统疾病,表现多样。影像学检查对于正确诊断该病很有必要;然而,确定该病的病因往往很困难。
一名原本健康的患者因特殊的神经系统症状前来就诊,无明显潜在病因。影像学检查未发现明显结构缺陷,但发现脊髓强化,符合横贯性脊髓炎的诊断。迅速开始使用皮质类固醇进行治疗以应对这一病理情况,患者康复且无后遗症。为确定潜在病因,对患者病史进行了全面回顾并与现有文献进行比较。既往结核感染可能不太可能是神经系统症状的病因。然而,近期接种强生公司的2019冠状病毒病(COVID-19)疫苗可能更有可能是横贯性脊髓炎的病因,这种情况鲜有报道。
COVID-19感染后发生横贯性脊髓炎的现象一直在增加。然而,COVID-19疫苗接种后发生横贯性脊髓炎是一种罕见但也在增加的情况。鉴于疫苗接种率上升,由于如果不迅速治疗这种疾病会导致严重的神经功能损害,横贯性脊髓炎作为一种潜在的病理情况不应被忽视。