Enoxaparin-induced Wunderlich syndrome in a young patient with anti-GAD 65-associated opsoclonus and limbic encephalitis: a rare complication in a rare disease.

Wunderlich syndrome is a rare condition characterised by acute spontaneous non-traumatic renal haemorrhage into the subcapsular and perirenal spaces. Our case of anti-GAD65-associated autoimmune encephalitis (AE), aged 30 years, developed this complication following use of enoxaparin and was managed by selective glue embolisation of subsegmental branches of right renal cortical arteries. Our case had opsoclonus as one of the clinical manifestations, which has till now been described in only two patients of this AE. This patient received all forms of induction therapies (steroids, plasmapheresis, intravenous immunoglobulin and rituximab) following which she had good improvement in her clinical condition. The good response to immunotherapy is also a point of discussion as this has been rarely associated with anti-GAD65 AE.

Limbic encephalitis in a COVID-19 patient?

We describe the case of a 79-year-old woman infected by SARS-CoV-2 and purely neurological confusional syndrome without clinically relevant respiratory disease and NMR alterations of the limbic system.

New-Onset Seizure With Possible Limbic Encephalitis in a Patient With COVID-19 Infection: A Case Report and Review.

With the outbreak of COVID-19 (coronavirus disease 2019) as a global pandemic, various of its neurological manifestations have been reported. We report a case of a 54-year-old male with new-onset seizure who tested positive for severe acute respiratory syndrome coronavirus 2 from a nasopharyngeal swab sample. Investigative findings, which included contrast-enhancing right posterior temporal lobe T2-hyperintensity on brain magnetic resonance imaging, right-sided lateralized periodic discharges on the electroencephalogram, and elevated protein level on cerebrospinal fluid analysis, supported the diagnosis of possible encephalitis from COVID-19 infection. The findings in this case are placed in the context of the existing literature.

Limbic Encephalitis as a Consequence of COVID-19 Infection (preprint)

Currently, worldwide coronavirus-19 (SARS-CoV-2) cases approach 80,000,000 and is spreading rapidly. As the pulmonary manifestations of the disease are well described, neurologic manifestations have become more well known in recent months. This case report recounts a previously healthy patient who was brought to the Emergency Department (ED) after a syncopal episode. In the ED, she was found to be drowsy with altered mental status. She was mildly hypoxemic, which improved with supplemental oxygen, and her chest X ray was normal. She was found to be positive for SARS-CoV-2. Several days later, an MRI of the brain was ordered to assess the etiology of her syncope and altered mentation, and revealed diffuse abnormal hyperintensities involving the right hippocampus. Though SARS-CoV-2 RNA of the patient's CSF was not performed, analysis was negative for bacteria or other viruses tested, prompting the likely diagnosis of limbic encephalitis secondary to COVID-19 infection.