Evidence of Post-COVID-19 Transverse Myelitis Demyelination

The COVID-19 infection is associated with neurological complications involving both the central and peripheral nervous systems. We present a case of a healthy 36-year-old woman who developed symptoms of transverse myelitis (TM) four weeks following a positive COVID-19 infection. She presented with severe fatigue, bilateral lower extremity ascending tingling, progressive muscle weakness, diminished sensation to pain, temperature and vibration, hyperreflexia, and neurogenic bladder. MRI showed extensive demyelination of the cervical and thoracic spine, and cerebrospinal fluid (CSF) analysis showed mildly elevated protein with normal cell count and no evidence of infection, including negative COVID-19 PCR. The patient was treated with intravenous methylprednisolone dosed daily for five days, and markedly improved and continued to he followed up closely at the office.