Kawama Kentaro, Shimazaki Rui, Sunami Yoko, Miyakoshi Natsuki, Tobisawa Shinsuke, Shimizu Toshio, Takahashi Kazushi
Department of Neurology, Tokyo Metropolitan Neurological Hospital, Tokyo, Japan.
Front Neurol. 2023 Oct 19;14:1275696. doi: 10.3389/fneur.2023.1275696. eCollection 2023.
Coronavirus Disease 2019 (COVID-19) is known to have various, neurological manifestations. We herein report three patients with MRI-negative myelitis following COVID-19 with abnormal somatosensory evoked potentials (SEPs). Decreased amplitude of the cortical potential and prolonged latency in the SEPs contributed to diagnosing myelitis in the present patients. The SEP findings improved as the neurological symptoms improved. Despite a delay in initiating immunosuppressive treatment after myelitis onset, all the patients improved clinically. In the light of recent progress in COVID-19 research, several hypotheses can be made to explain the pathophysiology underlying MRI-negative myelitis, including antibody-binding and microglial synapse elimination.
2019冠状病毒病(COVID-19)已知有多种神经表现。我们在此报告3例COVID-19后出现体感诱发电位(SEP)异常的MRI阴性脊髓炎患者。皮质电位波幅降低和SEP潜伏期延长有助于诊断本例患者的脊髓炎。随着神经症状改善,SEP结果也有所改善。尽管脊髓炎发作后开始免疫抑制治疗有所延迟,但所有患者临床症状均有改善。鉴于COVID-19研究的最新进展,可以提出几种假说来解释MRI阴性脊髓炎的病理生理学,包括抗体结合和小胶质细胞突触消除。