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Longitudinal extensive transverse myelitis following ChAdOx1 nCOV-19 vaccine: a case report


Tan, Wee Yong and Yusof Khan, Abdul Hanif Khan and Mohd Yaakob, Mohd Naim and Abdul Rashid, Anna Misyail and Loh, Wei Chao and Baharin, Janudin and Ibrahim, Azliza and Ismail, Mohd Redzuan and Inche Mat, Liyana Najwa and Wan Sulaiman, Wan Aliaa and Basri, Hamidon and Hoo, Fan Kee (2021) Longitudinal extensive transverse myelitis following ChAdOx1 nCOV-19 vaccine: a case report. BMC Neurology, 21. pp. 1-4. ISSN 1471-2377


Background: Transverse myelitis (TM) is a relatively uncommon condition, and vaccine-associated myelitis is even rarer. Concern regarding neurological complications following vaccination escalated following the report of TM during the safety and efcacy trials of the COVID-19 vaccine. Case presentation: We report the frst case of Longitudinal Extensive Transverse Myelitis (LETM) in Malaysia following administration of the chimpanzee adenovirus-vectored (ChAdOx1 nCoV-19) vaccine. A 25-year-old female presented with bilateral lower limb weakness and inability to walk with a sensory level up to T8 with absent visual symptoms. Urgent gadolinium-enhanced magnetic resonance imaging (MRI) of the spine showed long segment TM over the thoracic region. Cerebrospinal fuid autoantibodies for anti-aquaporin-4 and anti-myelin-oligodendrocyte were negative. A diagnosis of LETM following vaccination was made, and the patient was started on a high dose of intravenous methylprednisolone. The patient eventually made a recovery following treatment. Conclusion: LETM is a rare but serious adverse reaction following vaccination. Previously reported cases showed an onset of symptoms between 10 to 14days post-vaccination, suggesting a delayed immunogenic reaction. However, the incidence of myelitis in COVID-19 is much more common, far greater than the risk associated with vaccination.

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Additional Metadata

Item Type: Article
Divisions: Faculty of Medicine and Health Science
DOI Number: https://doi.org/10.1186/s12883-021-02427-x
Publisher: BioMed Central
Keywords: Myelitis; Transverse; COVID-19; Vaccination; Malaysia; Case report
Depositing User: Ms. Che Wa Zakaria
Date Deposited: 06 Mar 2023 04:20
Last Modified: 06 Mar 2023 04:20
Altmetrics: http://www.altmetric.com/details.php?domain=psasir.upm.edu.my&doi=10.1186/s12883-021-02427-x
URI: http://psasir.upm.edu.my/id/eprint/94049
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