Neurology, University of Utah Health, Salt Lake City, Utah, USA
Radiology, Chiba University, Chiba, Japan.
BMJ Case Rep. 2023 Nov 27;16(11):e257672. doi: 10.1136/bcr-2023-257672.
A woman in her 20s presented with ascending weakness and paraesthesia along with flu-like symptoms. Neurological examination revealed right facial numbness along V2 distribution and flaccidity in her lower extremities, with a motor power of 0/5 throughout. The T4 sensory level and bilaterally positive Babinski sign were noted. Brain MRI revealed multiple bilateral T2/fluid attenuated inversion recovery hyperintense lesions with central enhancement involving the right trigeminal nerve. Full spine MRI demonstrated long-segment thoracic cord demyelination extending from T1 to T11 and nerve root enhancement. An extensive workup for infectious and autoimmune aetiologies was conducted, which revealed a positive COVID-19 result. The patient was diagnosed with encephalomyeloradiculitis secondary to COVID-19 infection. Encephalomyeloradiculitis is a rare neurological condition associated with various underlying conditions. Understanding the causes and differentiating these conditions is essential for appropriate treatment.
一位 20 多岁的女性出现进行性无力和感觉异常,伴有类似流感的症状。神经系统检查显示右侧面部 V2 分布区麻木和下肢无力,四肢运动力量为 0/5。T4 感觉水平和双侧巴氏征阳性。脑部 MRI 显示多个双侧 T2/液体衰减反转恢复高信号病变,伴有正中强化,累及右侧三叉神经。全脊柱 MRI 显示从 T1 到 T11 的长节段胸髓脱髓鞘,并伴有神经根强化。对感染性和自身免疫性病因进行了广泛的检查,结果显示 COVID-19 检测结果为阳性。该患者被诊断为 COVID-19 感染引起的脑脊髓神经根炎。脑脊髓神经根炎是一种罕见的神经系统疾病,与多种潜在疾病有关。了解病因并对这些疾病进行鉴别对于适当的治疗至关重要。