A Rare Complication of COVID-19 in a Pediatric Patient; Acute Transverse Myelitis

There are various neurological complications of COVİD-19 in children. Some cases may have a serious course.

Here we wanted to present a 15-year-old otherwise healthy boy with transverse myelitis.

9 days before he presented to hospital he had a positive result of nasopharyngeal swap for SARS-CoV-2 nucleic asit test. On the 2nd day of seropositivity he developed symptoms of weakness, on 3rd day of seropositivity he was unable to stand and started falling. On 9th day of seropositivity he presented to emergency room with paraparesis. On neurologic examination, he was conscious, upper limbs power was normal, lower limb power was 3/5. His deep tendon reflexes in lower limbs were hyperactive, Babinski’s sign was positive and response to abdominal skin reflex was absent. The sensory level was at T9. He couldn’t able to walk and could sit with support. Meningeal signs were absent, and other systemic examinations were within normal limits. His laboratory findings for blood and cerebrospinal fluid (CSF) examination were all in normal range, brain magnetic resonance imaging (MRI) detected normal. Spinal MRI demonstrated T2-hyperintense, edema, expansile view of the spinal cord, extending from lower medulla to the conus medullaris level. In the post contrast series pathological contrast material uptake was most evident at T1-2 level. Pulse methylprednisolone therapy was given for 5 days. After treatment, he started to walk unsupported.

Here we want to present one of the para-infectious complications of COVİD-19 with good response to treatment.
Keywords: Acute Transverse Myelitis, COVİD-19, flaccid paralysis, pediatrics, SARS-CoV-2