Parainfectious Brown-Séquard syndrome associated with COVID-19

BMJ Case Rep, 2023 · DOI: 10.1136/bcr-2022-254496 · Published: September 9, 2023

Immunology Neurology Research Methodology & Design

Simple Explanation

This case report describes a patient who developed Brown-Séquard syndrome (BSS) during an active COVID-19 infection. BSS is a rare neurological condition resulting from damage to one side of the spinal cord. The patient experienced rapid improvement in neurological symptoms after being treated with high-dose steroids, suggesting an immune-mediated response to the COVID-19 infection. This case adds to the growing evidence of neurological complications associated with COVID-19 and supports the idea that the body's immune response to the virus can cause neurological damage.

Study Duration

Not specified

Participants

One adult male

Evidence Level

Level 4; Case Report

Key Findings

1
The patient presented with right hemiparesis and left-sided paresthesia during an active COVID-19 infection, confirmed by PCR.
2
MRI of the cervical spine revealed lesions on the right side of the spinal cord at levels C3-C4 and C5-C6.
3
The patient showed rapid clinical improvement with methylprednisolone treatment, suggesting an immune-mediated mechanism.

Research Summary

The report describes a case of Brown-Séquard syndrome (BSS) in an adult male with a recent COVID-19 infection. The patient's neurological symptoms rapidly improved after treatment with high-dose methylprednisolone, suggesting an immune-mediated response to COVID-19. This case contributes to the growing body of literature documenting neurological manifestations associated with COVID-19 and highlights a possible mechanism of neuropathogenesis.

Practical Implications

Diagnostic Awareness

Clinicians should consider BSS as a potential neurological complication in patients with active or recent COVID-19 infection.

Treatment Strategy

Early administration of high-dose glucocorticoids may be beneficial in COVID-19-related acute myelitis, particularly if an immune-mediated mechanism is suspected.

Further Research

Further studies are needed to fully understand the pathophysiology and impact of COVID-19 on the nervous system, as well as to develop optimal management strategies for COVID-19-related neurological conditions.

Study Limitations

1
Single case report limits generalizability.
2
The exact mechanism of neuropathogenesis remains unclear and requires further investigation.
3
Long-term outcomes and potential for recurrence are not fully elucidated.

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