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 efficacy trials of the COVID-19 vaccine. Case presentation We report the first 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 fluid 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 14 days 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.
【저자키워드】 COVID-19, vaccination, Malaysia, Case report, Myelitis, transverse, 【초록키워드】 Treatment, Efficacy, Vaccine, High dose, COVID-19 vaccine, Trial, magnetic resonance imaging, Diagnosis, risk, Symptoms, MRI, female, Patient, Myelitis, incidence, concern, longitudinal, ChAdOx1 nCoV-19, administration, Thoracic, Neurological complication, autoantibody, lower limb, transverse myelitis, weakness, intravenous methylprednisolone, Transverse, greater, reported, the patient, onset of symptom, Extensive, immunogenic reaction, serious adverse reaction, 【제목키워드】 longitudinal, ChAdOx1,