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  4. Longitudinally extensive transverse myelitis (LETM) secondary to SARS-CoV-2 infection: A recent reality in spinal cord injury rehabilitation

Longitudinally extensive transverse myelitis (LETM) secondary to SARS-CoV-2 infection: A recent reality in spinal cord injury rehabilitation

Clin Case Rep, 2022 · DOI: 10.1002/ccr3.5876 · Published: May 1, 2022

ImmunologyNeurologyRehabilitation

Simple Explanation

This paper describes a case of an 84-year-old man who developed transverse myelitis (TM) after a SARS-CoV-2 infection. TM is an inflammation of the spinal cord that can cause weakness and sensory problems. The patient initially presented with fever and tested positive for SARS-CoV-2 but was discharged. Two weeks later, he returned with urinary retention, lower limb weakness, and sensory loss, leading to the diagnosis of longitudinally extensive transverse myelitis (LETM). The patient underwent rehabilitation for four months, which resulted in significant improvements in motor function, balance, and independence in daily activities. This case highlights the importance of rehabilitation in managing neurological complications of COVID-19.

Study Duration
4 Months
Participants
One 84-year-old male
Evidence Level
Level 4: Case Report

Key Findings

  • 1
    SARS-CoV-2 infection can lead to longitudinally extensive transverse myelitis (LETM), even in older adults.
  • 2
    Rehabilitation plays a crucial role in improving functional outcomes for patients with LETM secondary to SARS-CoV-2 infection.
  • 3
    The patient showed significant improvement in motor function, balance, and independence in daily activities after a comprehensive rehabilitation program.

Research Summary

The case report describes an 84-year-old male who developed longitudinally extensive transverse myelitis (LETM) following a SARS-CoV-2 infection. The patient presented with urinary retention, lower limb weakness, and sensory loss. The patient underwent a comprehensive rehabilitation program for four months, which included respiratory kinesitherapy, joint mobilization, and muscle strengthening. Functional scales showed significant improvement at hospital discharge. The patient achieved autonomous gait with a pole, regained modified autonomy in activities of daily living, and showed improvement in FIM, SCIM, and nFAC scores, highlighting the effectiveness of rehabilitation in managing COVID-19-related neurological complications.

Practical Implications

Awareness of Neurological Complications

Physicians should be aware of the potential for SARS-CoV-2 to cause neurological complications like transverse myelitis.

Importance of Rehabilitation

Early and comprehensive rehabilitation is crucial for improving functional outcomes in patients with transverse myelitis secondary to COVID-19.

Multidisciplinary Approach

Management of transverse myelitis requires a multidisciplinary approach, including neurologists, physiatrists, and rehabilitation specialists.

Study Limitations

  • 1
    Single case report limits generalizability.
  • 2
    Lack of a control group.
  • 3
    Potential for other unidentified factors contributing to the patient's condition.

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