We report a 46 year old man who developed recurrent myelitis associated wit h hepatitis C viral (HCV) infection. Spinal cord biopsy showed acute demyelinati on without evidence of vasculitis. Antibodies to HCV were present in the CSF;HCV RNA was not detected in the CSF. Neither HCV antigens nor RNA were detected in the spinal cord biopsy, whereas they were found in the liver biopsy. Evaluation for other infectious or autoimmune causes was unrevealing. These observations su ggest that recurrent myelitis in this patient is etiologically related to HCV in fection, possibly via an immune mediated mechanism. This is the first report of pathologically proven myelitis associated with HCV infection and we suggest tha t HCV be considered in the differential diagnosis of the transverse myelitis syn drome.
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