Subject(s)
COVID-19/physiopathology , Cerebrovascular Disorders/physiopathology , Cognitive Dysfunction/physiopathology , Deglutition Disorders/physiopathology , Dysphonia/physiopathology , Executive Function , Adult , Angiography, Digital Subtraction , Basal Ganglia/diagnostic imaging , COVID-19/diagnostic imaging , Cerebral Angiography , Cerebrovascular Disorders/diagnostic imaging , Cerebrovascular Disorders/drug therapy , Diffusion Magnetic Resonance Imaging , Emergency Service, Hospital , Glucocorticoids/therapeutic use , Humans , Immunoglobulins, Intravenous/therapeutic use , Immunologic Factors/therapeutic use , Magnetic Resonance Imaging , Male , Methylprednisolone/therapeutic use , Patient Discharge , Pons/diagnostic imaging , Posterior Cerebral Artery/diagnostic imaging , SARS-CoV-2 , Severity of Illness Index , Thalamus/diagnostic imaging , Tomography, X-Ray Computed , White Matter/diagnostic imaging , COVID-19 Drug TreatmentABSTRACT
This is a case of a previously healthy female in her fourties presenting with a subacute presentation of bilateral horizontal gaze restriction, with bilateral lower motor facial palsy. The patient's daughter has type 1 diabetes. On investigation, the patient's MRI revealed a lesion in the dorsal medial pons. Cerebrospinal fluid analysis revealed albuminocytological dissociation, with a negative autoimmune panel. The patient was treated with intravenous immunoglobulin, and methylprednisolone for a total of 5 days and showed mild improvement. The patient had raised serum antiglutamic acid decarboxylase (anti-GAD) levels, and the final diagnosis of GAD seropositive brain stem encephalitis was made.
Subject(s)
Carboxy-Lyases , Encephalitis , Humans , Female , Encephalitis/diagnosis , Magnetic Resonance Imaging , Immunoglobulins, Intravenous , Pons , Glutamate Decarboxylase , AutoantibodiesABSTRACT
The new severe acute respiratory syndrome- coronavirus 2 is reported to affect the nervous system. Among the reports of the various neurological manifestations, there are a few documented specific processes to explain the neurological signs. We report a para-infectious encephalitis patient with clinical, laboratory, and imaging findings during evolution and convalescence phase of coronavirus infection. This comprehensive overview can illuminate the natural history of similar cases. As the two previously reported cases of encephalitis associated with this virus were not widely discussed regarding the treatment, we share our successful approach and add some recommendations about this new and scarce entity.