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Extensive neurological and functional recovery in an incomplete tetraplegic patient following transverse myelitis/ acute disseminated encephalomyelitis (ADEM) with rehabilitation: a challenging journey of a 17-Year-Old Girl

Spinal Cord Series and Cases volume 12, Article number: 2 (2026) Cite this article

Subjects

Abstract

Study design

Single case report.

Objective

We present a case of Tetraplegia due to Transverse Myelitis/ADEM with excellent rehabilitation outcome.

Setting

National Spinal Injuries Centre (NSIC), Stoke Mandeville Hospital, United Kingdom.

Case report

An 8-year-old girl presented with a severe acute neurological decline, initially involving a chest infection, four-limb paralysis, and deteriorating consciousness, which required intubation and mechanical ventilation. She was diagnosed with Transverse Myelitis/Acute Disseminated Encephalomyelitis (ADEM). MRI imaging of the brain and spine revealed significant T2 signal changes in the brainstem, as well as in the cervical spine (C2–C5).

Her rehabilitation focused on achieving independence in activities of daily living, with wheelchair assistance for mobility and support for transfer activities. This ongoing rehabilitation, conducted on both an inpatient and outpatient basis for a period of 8 years, led to remarkable progress. The patient showed significant neurological recovery, ultimately reaching an AIS-E classification, indicating complete recovery of motor and sensory function.

Conclusion

Spinal injury resulting from Transverse Myelitis can lead to widespread paralysis; however, prompt diagnosis and early specialist rehabilitation are crucial in promoting functional recovery and improving outcomes for affected individuals. The suggested “two-year” window for recovery in the adult population would appear to be extended in the paediatric population.

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References

  1. Greenberg BM. Transverse myelitis and acute disseminated encephalomyelitis. Multiple Scler CNS Inflamm Disord. 2014:144-52.

  2. Gupta A, Kumar SN, Taly AB. Neurological and functional recovery in acute transverse myelitis patients with inpatient rehabilitation and magnetic resonance imaging correlates. Spinal Cord. 2016;54:804–8.

    Article  CAS  PubMed  Google Scholar 

  3. DeSena A, Graves D, Morriss MC, Greenberg BM. Transverse myelitis plus syndrome and acute disseminated encephalomyelitis plus syndrome: a case series of 5 children. JAMA Neurol. 2014;71:624–9.

    Article  PubMed  Google Scholar 

  4. Sato M, Sugiyama K, Kondo T, Izumi S-I. Rehabilitation for paraplegia caused by neuromyelitis optica: a case report. Spinal Cord. 2014;52:S14–S15.

    Article  PubMed  Google Scholar 

  5. Sadowsky CL, Becker D, Bosques G, Dean JM, McDonald JW 3rd, Recio A, et al. Rehabilitation in transverse myelitis. CONTINUUM. 2011;17:816–30.

    Article  PubMed  Google Scholar 

  6. Kaplin AI, Krishnan C, Deshpande DM, Pardo CA, Kerr DA. Diagnosis and management of acute myelopathies. Neurologist. 2005;11:2–18.

    Article  PubMed  Google Scholar 

  7. Nakipoglu GF, Ozgirgin N. Urodynamic evaluation and rehabilitation outcomes in transverse myelitis. Neurosci J. 2009;14:37–40.

    Google Scholar 

  8. Gupta A, Taly AB, Srivastava A, Murali T, Thyloth M, Sinha S, et al. Non-traumatic spinal cord lesions: epidemiology, complications, neurological and functional outcome of rehabilitation. Spinal Cord. 2009;47:307–11.

    Article  CAS  PubMed  Google Scholar 

  9. Debette S, de Sèze J, Pruvo JP, Zephir H, Pasquier F, Leys D, et al. Long-term outcome of acute and subacute myelopathies. J Neurol. 2009;256:980–8.

    Article  CAS  PubMed  Google Scholar 

  10. Lena E, Baroncini I, Pavese C, Musumeci G, Volini S, Masciullo M, et al. Reliability and validity of the international standards for neurological classification of spinal cord injury in patients with non-traumatic spinal cord lesions. Spinal Cord. 2022;60:30–36.

    Article  PubMed  Google Scholar 

  11. Estes TM, Tompkins E, Pristas NE, Lindberg RH. Dual spinal cord injury: a case of acute traumatic T9 AIS A spinal cord injury complicated by transverse myelitis. Spinal Cord Ser Cases. 2020;6:81.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Bellinvia A, Pastò L, Razzolini L, Fratangelo R, Prestipino E, Fonderico M, et al. The clinical spectrum of anti-MOG associated acquired demyelinating disorders: three case reports. Multiple Scler Relat Disord. 2019;33:51–54.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

The authors thank Dr Mustafa Albayrak, and all the medical staff who were involved with the overall patients care.

Author information

Authors and Affiliations

  1. National Spinal Injuries Centre, Stoke Mandeville Hospital, Buckinghamshire NHS Trust, Aylesbury, UK

    Akter Hossain & A. Rouse

Authors
  1. Akter Hossain
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  2. A. Rouse
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Contributions

Akter Hossain: Obtained consent, drafted and wrote the manuscript. Dr. A. Rouse: Provide supervision, edited, and reviewed the manuscript.

Corresponding author

Correspondence to Akter Hossain.

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The authors declare no competing interests.

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Hossain, A., Rouse, A. Extensive neurological and functional recovery in an incomplete tetraplegic patient following transverse myelitis/ acute disseminated encephalomyelitis (ADEM) with rehabilitation: a challenging journey of a 17-Year-Old Girl. Spinal Cord Ser Cases 12, 2 (2026). https://doi.org/10.1038/s41394-026-00728-2

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