Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 6 de 6
Filter
1.
BMC Neurol ; 22(1): 54, 2022 Feb 12.
Article in English | MEDLINE | ID: covidwho-1677495

ABSTRACT

BACKGROUND: Acute disseminated encephalomyelitis (ADEM) is a rare immune-mediated inflammatory demyelinating disease of the central nervous system. We report a case of ADEM presenting with bilateral optic neuritis temporally associated with the ChAdOx1 vaccine against SARS-COVID19 virus. CASE PRESENTATION: A 36-year-old female presented with bilateral optic neuritis following her first dose of the ChAdOx1 vaccine. Initial MRI Brain showed evidence of demyelination within the subcortical white matter, with no radiological involvement of the optic nerves. Visual evoked potentials were consistent with bilateral optic neuritis which was confirmed radiologically on follow up MRI. She was treated with intravenous steroids with improvement both in symptoms and radiological appearance. A pseudo-relapse occurred which was treated with a further course of intravenous steroids followed by an oral taper. The clinical, radiological and serological results were most consistent with diagnosis of ADEM. CONCLUSIONS: ADEM is an exceedingly rare complication of ChAdOx1 vaccine despite millions of doses. While it is imperative clinicians remain aware of neurological complications of vaccines, the importance of vaccination to control a pandemic should not be undermined.


Subject(s)
COVID-19 , Encephalomyelitis, Acute Disseminated , Optic Neuritis , Adult , COVID-19 Vaccines , Encephalomyelitis, Acute Disseminated/diagnostic imaging , Encephalomyelitis, Acute Disseminated/drug therapy , Encephalomyelitis, Acute Disseminated/etiology , Evoked Potentials, Visual , Female , Humans , Optic Neuritis/drug therapy , Optic Neuritis/etiology , SARS-CoV-2 , Vaccination
2.
J Neuroimmunol ; 359: 577674, 2021 10 15.
Article in English | MEDLINE | ID: covidwho-1330985

ABSTRACT

Acute disseminated encephalomyelitis (ADEM) has been reported after coronavirus disease 2019 (COVID-19). In this review, we systematically included worldwide reported cases on this association. We included 30 case reports (pediatric and adults) and explored epidemiological and clinical evidence. We described time to diagnosis, clinical, imaging, and laboratory features, response to treatment regimens, and differences regarding severity. Also, an original case report was presented. Neurologists must be alert to the occurrence of multifocal neurological symptoms with or without encephalopathy in patients recovered from COVID-19. Timely MRI studies should be performed to establish the diagnosis and to consider early corticosteroid-based treatment.


Subject(s)
COVID-19/complications , COVID-19/diagnostic imaging , Encephalomyelitis, Acute Disseminated/diagnostic imaging , Encephalomyelitis, Acute Disseminated/etiology , Global Health , Adult , COVID-19/drug therapy , Encephalomyelitis, Acute Disseminated/drug therapy , Humans , Male , Methylprednisolone/therapeutic use , Observational Studies as Topic/methods
3.
Neurol Sci ; 42(10): 4293-4296, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1226223

ABSTRACT

INTRODUCTION: Sars-CoV-2 is a single-strained RNA virus belonging to Coronaviridae's family. In pediatric age, the majority of patients is asymptomatic; however, several neurological manifestations associated with Sars-CoV-2 infection have been detected in a percentage of cases ranging from 17.3 to 36.4%. Acute disseminated encephalomyelitis (ADEM) has been recently included among the potential complications of Sars-Cov2 infection. The available data regarding pediatric patient show only one case. CASE REPORT: We present a case regarding a 6-year-old patient suffering from Fisher-Evans syndrome who was given sirolimus and thalidomide therapy. After 10 days since the first positive nasopharyngeal swab for Sars-CoV-2, in which he had no symptoms, he presented an episode of generalized tonic-clonic seizure with spontaneous resolution. The patient underwent MRI which showed the typical picture of acute disseminated encephalomyelitis. His clinical course was favorable, with a good response to cortisone therapy and a progressive improvement of the neuroradiological and electroencephalographic picture. CONCLUSIONS: According to our knowledge, this is the second case of an acute disseminated encephalomyelitis following SARS-CoV-2 infection in a pediatric patient, characterized by monosymptomatic onset, in which the immunosuppressive therapy practiced for the Fisher-Evans syndrome has probably contributed to a favorable evolution of ADEM, in contrast to other case described in the literature.


Subject(s)
COVID-19 , Encephalomyelitis, Acute Disseminated , Anemia, Hemolytic, Autoimmune , Child , Encephalomyelitis, Acute Disseminated/diagnostic imaging , Encephalomyelitis, Acute Disseminated/drug therapy , Encephalomyelitis, Acute Disseminated/etiology , Humans , Male , RNA, Viral , SARS-CoV-2 , Thrombocytopenia
4.
BMJ Case Rep ; 13(12)2020 Dec 13.
Article in English | MEDLINE | ID: covidwho-975665

ABSTRACT

A 53-year-old man admitted to the critical care secondary to respiratory failure due to COVID-19 developed agitation and global hypotonia. Brain MRI revealed bilateral hyperintense lesions throughout the brain and cerebrospinal fluid identified oligoclonal bands. Intravenous high-dose glucocorticoids were administered followed by an oral tapering dose and the patient clinically improved. Acute disseminated encephalomyelitis should be considered in patients with COVID-19 who present with altered mentation and polyfocal neurological deficits.


Subject(s)
COVID-19/complications , Encephalomyelitis, Acute Disseminated/virology , Encephalomyelitis, Acute Disseminated/diagnostic imaging , Encephalomyelitis, Acute Disseminated/drug therapy , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Neuroimaging , SARS-CoV-2
5.
Neurol India ; 68(5): 1192-1195, 2020.
Article in English | MEDLINE | ID: covidwho-895446

ABSTRACT

OBJECTIVE: The purpose of this study was to report three patients COVID-19 infection with severe respiratory syndrome requiring intubation, who developed acute demyelinating encephalomyelitis (ADEM). METHODS: Patient data were obtained from medical records from the North Memorial Hospital, Robbinsdale, MN, USA. RESULTS: Three patients (two men and one woman, aged 38-63) presented with fatigue, cough, and fever leading to acute respiratory distress syndrome secondary to COVID-19 infection requiring ventilatory support. Two patients were unresponsive and the third patient had severe diffuse weakness. MRI in all patients showed findings consistent with ADEM. CSF showed elevated protein in all patients with normal cell count and no evidence of infection, including negative COVID-19 PCR. All three patients were treated with intravenous corticosteroids and one improved markedly. The other two had minimal response to steroids and no further improvement after IVIG. CONCLUSION: Neurological complications from COVID-19 are being rapidly recognized. Our three cases highlight the occurrence of ADEM as a postinfectious/immune-mediated complication of COVID-19 infection, which may be responsive to corticosteroid treatment.


Subject(s)
Coronavirus Infections/complications , Encephalomyelitis, Acute Disseminated/etiology , Pneumonia, Viral/complications , Adult , Aged , Betacoronavirus , COVID-19 , Consciousness Disorders/etiology , Diabetes Mellitus, Type 2/complications , Encephalomyelitis, Acute Disseminated/cerebrospinal fluid , Encephalomyelitis, Acute Disseminated/diagnostic imaging , Encephalomyelitis, Acute Disseminated/drug therapy , Female , Glucocorticoids/therapeutic use , Humans , Hypertension/complications , Male , Middle Aged , Muscle Weakness/etiology , Obesity/complications , Pandemics , Pregnancy , Pregnancy Complications, Infectious , Renal Insufficiency, Chronic/complications , SARS-CoV-2
6.
J Neurol ; 267(10): 2799-2802, 2020 Oct.
Article in English | MEDLINE | ID: covidwho-436435

ABSTRACT

A 51-year-old woman with COVID-19 infection developed coma and an impaired oculocephalic response to one side. MRI of the brain demonstrated acute multifocal demyelinating lesions, and CSF testing did not identify a direct cerebral infection. High-dose steroids followed by a course of IVIG was administered, and the patient regained consciousness over the course of several weeks. As more patients reach the weeks after initial infection with COVID-19, acute disseminated encephalomyelitis should be considered a potentially treatable cause of profound encephalopathy or multifocal neurological deficits.


Subject(s)
Coronavirus Infections/complications , Encephalomyelitis, Acute Disseminated/virology , Pneumonia, Viral/complications , Anti-Inflammatory Agents/therapeutic use , Betacoronavirus , COVID-19 , Encephalomyelitis, Acute Disseminated/drug therapy , Encephalomyelitis, Acute Disseminated/pathology , Female , Humans , Immunoglobulins, Intravenous/therapeutic use , Methylprednisolone/therapeutic use , Middle Aged , Pandemics , SARS-CoV-2
SELECTION OF CITATIONS
SEARCH DETAIL