Longitudinal extensive transverse myelitis following ChAdOx1 nCOV-19 vaccine: a case report

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 efcacy trials of the COVID-19 vaccine. Case presentati...

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Main Authors: Tan, Wee Yong, Yusof Khan, Abdul Hanif Khan, Mohd Yaakob, Mohd Naim, Abdul Rashid, Anna Misyail, Loh, Wei Chao, Baharin, Janudin, Ibrahim, Azliza, Ismail, Mohd Redzuan, Inche Mat, Liyana Najwa, Wan Sulaiman, Wan Aliaa, Basri, Hamidon, Hoo, Fan Kee
Format: Article
Published: BioMed Central 2021
Online Access:http://psasir.upm.edu.my/id/eprint/94049/
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author Tan, Wee Yong
Yusof Khan, Abdul Hanif Khan
Mohd Yaakob, Mohd Naim
Abdul Rashid, Anna Misyail
Loh, Wei Chao
Baharin, Janudin
Ibrahim, Azliza
Ismail, Mohd Redzuan
Inche Mat, Liyana Najwa
Wan Sulaiman, Wan Aliaa
Basri, Hamidon
Hoo, Fan Kee
author_facet Tan, Wee Yong
Yusof Khan, Abdul Hanif Khan
Mohd Yaakob, Mohd Naim
Abdul Rashid, Anna Misyail
Loh, Wei Chao
Baharin, Janudin
Ibrahim, Azliza
Ismail, Mohd Redzuan
Inche Mat, Liyana Najwa
Wan Sulaiman, Wan Aliaa
Basri, Hamidon
Hoo, Fan Kee
author_sort Tan, Wee Yong
building UPM Institutional Repository
collection Online Access
description 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 efcacy trials of the COVID-19 vaccine. Case presentation: We report the frst 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 fuid 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 14days 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.
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institution Universiti Putra Malaysia
institution_category Local University
last_indexed 2025-11-15T13:08:32Z
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spelling upm-940492023-03-06T04:20:58Z http://psasir.upm.edu.my/id/eprint/94049/ Longitudinal extensive transverse myelitis following ChAdOx1 nCOV-19 vaccine: a case report Tan, Wee Yong Yusof Khan, Abdul Hanif Khan Mohd Yaakob, Mohd Naim Abdul Rashid, Anna Misyail Loh, Wei Chao Baharin, Janudin Ibrahim, Azliza Ismail, Mohd Redzuan Inche Mat, Liyana Najwa Wan Sulaiman, Wan Aliaa Basri, Hamidon Hoo, Fan Kee 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 efcacy trials of the COVID-19 vaccine. Case presentation: We report the frst 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 fuid 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 14days 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. BioMed Central 2021-10-12 Article PeerReviewed Tan, Wee Yong and Yusof Khan, Abdul Hanif Khan and Mohd Yaakob, Mohd Naim and Abdul Rashid, Anna Misyail and Loh, Wei Chao and Baharin, Janudin and Ibrahim, Azliza and Ismail, Mohd Redzuan and Inche Mat, Liyana Najwa and Wan Sulaiman, Wan Aliaa and Basri, Hamidon and Hoo, Fan Kee (2021) Longitudinal extensive transverse myelitis following ChAdOx1 nCOV-19 vaccine: a case report. BMC Neurology, 21. pp. 1-4. ISSN 1471-2377 https://bmcneurol.biomedcentral.com/articles/10.1186/s12883-021-02427-x 10.1186/s12883-021-02427-x
spellingShingle Tan, Wee Yong
Yusof Khan, Abdul Hanif Khan
Mohd Yaakob, Mohd Naim
Abdul Rashid, Anna Misyail
Loh, Wei Chao
Baharin, Janudin
Ibrahim, Azliza
Ismail, Mohd Redzuan
Inche Mat, Liyana Najwa
Wan Sulaiman, Wan Aliaa
Basri, Hamidon
Hoo, Fan Kee
Longitudinal extensive transverse myelitis following ChAdOx1 nCOV-19 vaccine: a case report
title Longitudinal extensive transverse myelitis following ChAdOx1 nCOV-19 vaccine: a case report
title_full Longitudinal extensive transverse myelitis following ChAdOx1 nCOV-19 vaccine: a case report
title_fullStr Longitudinal extensive transverse myelitis following ChAdOx1 nCOV-19 vaccine: a case report
title_full_unstemmed Longitudinal extensive transverse myelitis following ChAdOx1 nCOV-19 vaccine: a case report
title_short Longitudinal extensive transverse myelitis following ChAdOx1 nCOV-19 vaccine: a case report
title_sort longitudinal extensive transverse myelitis following chadox1 ncov-19 vaccine: a case report
url http://psasir.upm.edu.my/id/eprint/94049/
http://psasir.upm.edu.my/id/eprint/94049/
http://psasir.upm.edu.my/id/eprint/94049/