Case report: MRI-negative myelitis following COVID-19 with SEP abnormalities: a case series and literature review

Kentaro Kawama; Rui Shimazaki; Yoko Sunami; Natsuki Miyakoshi; Shinsuke Tobisawa; Toshio Shimizu; Kazushi Takahashi

doi:10.3389/fneur.2023.1275696

Case report: MRI-negative myelitis following COVID-19 with SEP abnormalities: a case series and literature review

Front Neurol. 2023 Oct 19:14:1275696. doi: 10.3389/fneur.2023.1275696. eCollection 2023.

Authors

Kentaro Kawama¹, Rui Shimazaki¹, Yoko Sunami¹, Natsuki Miyakoshi¹, Shinsuke Tobisawa¹, Toshio Shimizu¹, Kazushi Takahashi¹

Affiliation

¹ Department of Neurology, Tokyo Metropolitan Neurological Hospital, Tokyo, Japan.

Abstract

Coronavirus Disease 2019 (COVID-19) is known to have various, neurological manifestations. We herein report three patients with MRI-negative myelitis following COVID-19 with abnormal somatosensory evoked potentials (SEPs). Decreased amplitude of the cortical potential and prolonged latency in the SEPs contributed to diagnosing myelitis in the present patients. The SEP findings improved as the neurological symptoms improved. Despite a delay in initiating immunosuppressive treatment after myelitis onset, all the patients improved clinically. In the light of recent progress in COVID-19 research, several hypotheses can be made to explain the pathophysiology underlying MRI-negative myelitis, including antibody-binding and microglial synapse elimination.

Keywords: COVID-19; MRI; SEPs; microglia; myelitis.

Publication types

Case Reports

Grants and funding

The author(s) declare that no financial support was received for the research, authorship, and/or publication of this article.