Disclosures: Steven A. Tijmes, DO: No financial relationships or conflicts of interest

Case Diagnosis: 79-year-old female developed acute transverse myelitis following COVID-19 vaccination

Case Description: A 79-year-old woman presented to the hospital with a complaint of bilateral upper extremity weakness. She had recently received the second dose of the COVID-19 vaccine two and a half weeks prior to the onset of her symptoms. The patient underwent MRI imaging of her brain and cervical spine which revealed increased signal intensity extending from C4 to C6-C7. The patient was evaluated by neurology and determined to have transverse myelitis.

Setting: Inpatient rehabilitation facilityAssessment/

Results: The patient underwent treatment with intravenous methylprednisolone and her condition began to improve. She was transitioned to an oral steroid taper and did not require intravenous immunoglobulin or plasma exchange. She was admitted to our acute rehabilitation facility where she was found to need moderate assistance for transfers and minimal assistance for ambulation. She also required moderate to total assistance for dressing.

Discussion: Transverse myelitis has been associated with certain viral illnesses. More rarely, it has been seen following certain vaccinations. This unique case is particularly important as it demonstrates a possible link between transverse myelitis and the COVID-19 vaccine. This case was therefore reported to the FDA. At least one other case of transverse myelitis has been reported as an adverse event linked to receiving a COVID-19 booster vaccine during the vaccine trials. There are currently multiple vaccines against COVID-19 being used in the United States which have been FDA approved and are currently undergoing phase 4 trials. Therefore, healthcare professionals must continue to observe for possible adverse events associated with the vaccine.

Conclusion: While there is currently insufficient data to form a direct association between the COVID-19 vaccine and transverse myelitis, it is vitally important for healthcare professionals to remain vigilant for potential adverse events and report them to the FDA as appropriate.

Level of Evidence: Level V

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/acute-transverse-myelitis-following-covid-19-vaccination-a-case-report/