ABSTRACT
Case Diagnosis: A 58-year-old female, part time health care provider, with history of brain meningioma excision with residual bilateral foot drop, with new diagnosis of COVID-19 Cerebellitis Case Description or Program Description: The patient was admitted at a tertiary hospital due to malaise, fever, chills, cough, nausea, vomiting, dizziness, slurred speech, and fall. She did not have diplopia, dysphagia, or dyspnea requiring supplemental oxygen. COVID-19 test was positive. Extensive work-up for cerebrovascular, metabolic, and paraneoplastic etiologies including brain magnetic resonance imaging, head and neck computed tomography angiogram, full body positron emission tomography, and lumbar puncture with cerebral spinal fluid analysis were conducted. Neurology diagnosed her to have COVID-19 cerebellitis. Aspirin 81 mg daily and a 10-day course of oral Dexamethasone 6 mg daily were initiated and she was admitted to the Inpatient Rehabilitation Facility (IRF). She was seen by physical therapy, occupational therapy, speech language pathology, recreational therapy, rehabilitation psychology, and Internal Medicine. She had dysarthria, ataxia, and required minimum assistance to transfer and bathe, moderate assistance to dress, stand, and walk 32 feet using a rolling walker (RW) and bilateral ankle foot orthoses (AFOs), and maximum assistance for toileting. persisted with Meclizine but resolved with Scopolamine patch. Setting(s): Inpatient Rehabilitation Hospital Assessment/Results: She stayed 18 days in the IRF. Her Berg Balance Scale score improved from 13 to 23. On discharge, she had progressed to being independent in all activities of daily living, modified independent with transfers, and needed only contact guard assistance to use stairs and walk 80 feet using her RW and AFOs. She had mild dysarthria but 90% intelligible speech. Home Health services were arranged. Discussion (relevance): There have been only a few reported cases of COVID-19 cerebellitis. To our knowledge, this is the first reported case of Inpatient Rehabilitation of a patient with COVID-19 cerebellitis. Conclusion(s): Inpatient rehabilitation is beneficial for treating COVID-19 cerebellitis.