Longitudinally extensive transverse myelitis after covid vaccination: Response to letter

We thank Finsterer for the letter¹ and important points concerning our recent case report, “Longitudinally extensive transverse myelitis after Covid-19 vaccination: case report and review of literature.”²

Regarding the raised concerns over our diagnosis, routine tests, including thyroid function tests (TFT), were performed and were normal. CSF sample was evaluated for infectious agents including Covid, HSV, TB, etc. Brain MRI was performed and was normal, and due to the patient’s good response to corticosteroids both clinically and radiologically, the patient was unlikely to have infectious diseases.

We did not measure interleukins, cytokines, and glial factors in CSF sample as these factors are considered nonspecific and might increase in other causes of myelitis.

In our case, the onset of symptoms was 21 days after vaccination which is considered acceptable as neurological complications have been reported in various studies for up to 4 weeks.³ The patient was referred to our clinic 14 days after the onset of symptoms which was due to her prior visit to another center (where she was not diagnosed).

The number of reported neurological complications following Covid vaccination is not high. Despite the widespread vaccination, there are not as many reported cases of myelitis as expected (16 cases versus 11.29 billion doses). This is partly due to the reporting of patients with severe complications such as: stroke, Guillain Barre syndrome, facial palsy, transverse myelitis, and acute disseminated encephalomyelitis as well.⁴ Also, the manuscript was drafted in April 2021 and unfortunately was not updated by the time of publication.

Funding Statement

The author(s) reported there is no funding associated with the work featured in this article.

Disclosure statement

No potential conflict of interest was reported by the authors.