Covid-19 infection-induced neuromyelitis optica: a case report

Abstract

Introduction: Acute respiratory syndrome coronavirus-2 (Covid-19) can infect the respiratory system, as well as the central, peripheral nervous system, and muscles, leading to neurological symptoms and signs. The most common neurological symptoms are dizziness, headache, impaired consciousness, ataxia, hypogosis, hyposmia, neuralgia, and myalgia. The most common neurological diseases are acute cerebrovascular disease, epilepsy, acute hemorrhagic necrotizing encephalopathy, miyelitis, and Gullian-Barre syndrome.

Methods: In this case report, a patient infected with Covid-19 and diagnosed as neuromyelitis optica (NMO) with anamnesis, clinical and radiological findings is presented.

Results: A 50-year-old woman presented with weakness of both legs, urine retention, high fever, and cough. Spinal magnetic resonance imaging revealed expensive long-segment and centrally located demyelinating lesion extending from the cervical cord (at the level of C3) to the conus. Thoracic-computerized tomography revealed consolidation areas located on the lower segments of bilateral lungs and ground-glass density, air bronchograms, and peribronchial thickening surrounding these areas. Aquaporin-4 immune globulin-G was found to be positive.

Conclusion: It was considered appropriate to present this case because of being the first case of parainfectious NMO considered to be induced by SARS-CoV-2.

Keywords: Covid-19; demyelinating lesion; neuromyelitis optica; parainfectious myelitis; spinal cord.