Elisa Fumi Akagi Fukushima1, Abdulla Nasser2, Ashish Bhargava1, Shyam Moudgil3. 1. MD, Department of Internal Medicine, Division of Infectious Disease, Ascension St. John Hospital, 22101 Moross Rd, Detroit, MI 48236, USA. 2. MD, Department of Internal Medicine, Ascension St. John Hospital, 22101 Moross Rd, Detroit, MI 48236, USA. 3. MD, Department of Internal Medicine, Division of Neurology, Ascension St. John Hospital, 22101 Moross Rd, Detroit, MI 48236, USA.
Abstract
INTRODUCTION: Several publications described neurological manifestations caused by SARS-CoV-2. Immune-mediated neurological damages caused by COVID-19 are increasingly recognized. CASE REPORT: A young male presented in March 2020 with a new-onset seizure. Later, he started to experience a severe headache. During the second admission in May, the MRI of the brain showed left frontal lesion. Nasal PCR for SARS-CoV-2 was negative, but the serology was positive, raising the suspicion of immune-mediated encephalitis. Elevated cerebrospinal fluid immunoglobulin G with two oligoclonal bands were also seen. The patient received IV immunoglobulin and showed improvement in headache. Follow-up MRIs of the brain revealed complete resolution of the lesion. DISCUSSION: Neurological complications from COVID-19 have been increasingly recognized. The proposed pathophysiology is either direct damage of neurological tissues, or indirectly through immune-mediated mechanisms. The timeline of the patient's presentation with seizure, as well as the lesion on the brain MRI with complete resolution after the IV immunoglobulin, strongly suggest that the patient had immune-mediated encephalitis after exposure to SARS-CoV-2. CONCLUSIONS: Several cases of encephalitis caused by SARS-CoV-2 have been reported. Immune-mediated encephalitis as probable pathophysiology is described here. GERMS.
INTRODUCTION: Several publications described neurological manifestations caused by SARS-CoV-2. Immune-mediated neurological damages caused by COVID-19 are increasingly recognized. CASE REPORT: A young male presented in March 2020 with a new-onset seizure. Later, he started to experience a severe headache. During the second admission in May, the MRI of the brain showed left frontal lesion. Nasal PCR for SARS-CoV-2 was negative, but the serology was positive, raising the suspicion of immune-mediated encephalitis. Elevated cerebrospinal fluid immunoglobulin G with two oligoclonal bands were also seen. The patient received IV immunoglobulin and showed improvement in headache. Follow-up MRIs of the brain revealed complete resolution of the lesion. DISCUSSION: Neurological complications from COVID-19 have been increasingly recognized. The proposed pathophysiology is either direct damage of neurological tissues, or indirectly through immune-mediated mechanisms. The timeline of the patient's presentation with seizure, as well as the lesion on the brain MRI with complete resolution after the IV immunoglobulin, strongly suggest that the patient had immune-mediated encephalitis after exposure to SARS-CoV-2. CONCLUSIONS: Several cases of encephalitis caused by SARS-CoV-2 have been reported. Immune-mediated encephalitis as probable pathophysiology is described here. GERMS.
Authors: Consuelo Gutiérrez-Ortiz; Antonio Méndez-Guerrero; Sara Rodrigo-Rey; Eduardo San Pedro-Murillo; Laura Bermejo-Guerrero; Ricardo Gordo-Mañas; Fernando de Aragón-Gómez; Julián Benito-León Journal: Neurology Date: 2020-04-17 Impact factor: 9.910
Authors: Ross W Paterson; Rachel L Brown; Laura Benjamin; Ross Nortley; Sarah Wiethoff; Tehmina Bharucha; Dipa L Jayaseelan; Guru Kumar; Rhian E Raftopoulos; Laura Zambreanu; Vinojini Vivekanandam; Anthony Khoo; Ruth Geraldes; Krishna Chinthapalli; Elena Boyd; Hatice Tuzlali; Gary Price; Gerry Christofi; Jasper Morrow; Patricia McNamara; Benjamin McLoughlin; Soon Tjin Lim; Puja R Mehta; Viva Levee; Stephen Keddie; Wisdom Yong; S Anand Trip; Alexander J M Foulkes; Gary Hotton; Thomas D Miller; Alex D Everitt; Christopher Carswell; Nicholas W S Davies; Michael Yoong; David Attwell; Jemeen Sreedharan; Eli Silber; Jonathan M Schott; Arvind Chandratheva; Richard J Perry; Robert Simister; Anna Checkley; Nicky Longley; Simon F Farmer; Francesco Carletti; Catherine Houlihan; Maria Thom; Michael P Lunn; Jennifer Spillane; Robin Howard; Angela Vincent; David J Werring; Chandrashekar Hoskote; Hans Rolf Jäger; Hadi Manji; Michael S Zandi Journal: Brain Date: 2020-10-01 Impact factor: 13.501
Authors: Daniel Modin; Brian Claggett; Caroline Sindet-Pedersen; Mats Christian Højbjerg Lassen; Kristoffer Grundtvig Skaarup; Jens Ulrik Stæhr Jensen; Michael Fralick; Morten Schou; Morten Lamberts; Thomas Gerds; Emil Loldrup Fosbøl; Matthew Phelps; Kristian Hay Kragholm; Mikkel Porsborg Andersen; Lars Køber; Christian Torp-Pedersen; Scott D Solomon; Gunnar Gislason; Tor Biering-Sørensen Journal: Circulation Date: 2020-10-15 Impact factor: 29.690
Authors: Jakub Udzik; Paweł Jakubowski; Małgorzata Niekrasz; Adrian Barczyszyn; Miłosz Parczewski Journal: J Clin Med Date: 2022-02-13 Impact factor: 4.241
Authors: Jaafar Omer Ahmed; Shwan Abdubakr Ahmad; Marwan Nasih Hassan; Fahmi H Kakamad; Rawezh Q Salih; Berwn A Abdulla; Fattah Hama Rahim Fattah; Shvan H Mohammed; Razhan K Ali; Abdulwahid M Salih Journal: Ann Med Surg (Lond) Date: 2022-03-03