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Parainfectious Brown-Séquard syndrome associated with COVID-19
  1. Lily Ye Chen1,
  2. Rachel Diem-Trang Truong1 and
  3. Sampathkumar Shanmugham1,2
  1. 1Department of Medicine, University of Central Florida College of Medicine, Orlando, Florida, USA
  2. 2Department of Internal Medicine, HCA Florida Lake Monroe Hospital, Sanford, Florida, USA
  1. Correspondence to Dr Lily Ye Chen; Lchen639{at}


Acute myelitis encompasses syndromes associated with inflammation of the spinal cord. In cases of inflammatory lesions that only involve a unilateral portion of the axial plane of the cord, Brown-Séquard syndrome may occur, resulting in potential ipsilateral corticospinal, dorsal spinocerebellar, or dorsal column dysfunction or contralateral spinothalamic dysfunction below the level of the lesion. We report a case of an adult male who presented with Brown-Séquard syndrome and with a positive SARS-CoV-2 nasopharyngeal swab PCR test. Neurological symptoms rapidly resolved after initiation of high-dose methylprednisolone. The findings reported not only contribute to documenting a new presentation of neurological complications associated with SARS-CoV-2 infection but also non-exclusively supports the body of literature suggesting the immune-mediated response to this infection as a mechanism of neuropathogenesis. In this case, COVID-19-related acute myelitis responded to treatment with a short regimen of high-dose glucocorticoids.

  • Infection (neurology)
  • Spinal cord
  • Medical management
  • COVID-19

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  • Contributors LYC was the lead writer of the case report. R-DTT contributed to the manuscript writing and editing and was involved in data interpretation. SS was the neurologist involved in the patient’s care, obtained patient consent, acquired and provided interpretation of data and images, and SS was involved in writing and editing of the manuscript. All authors have read, edited and authorised the final version of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.