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Acute encephalitis in pediatric multisystem inflammatory syndrome associated with COVID-19.
Olivotto, Sara; Basso, Eleonora; Lavatelli, Rossella; Previtali, Roberto; Parenti, Laura; Fiori, Laura; Dilillo, Dario; Zuccotti, Gian Vincenzo; Veggiotti, Pierangelo; Bova, Stefania Maria.
  • Olivotto S; Vittore Buzzi Children's Hospital, Pediatric Neurology Unit, Via Castelvetro, 32, 20154, Milan, Italy. Electronic address: sara.olivotto@asst-fbf-sacco.it.
  • Basso E; University of Milan, Via Festa del Perdono 7, 20122, Milan, Italy. Electronic address: eleonora.basso@unimi.it.
  • Lavatelli R; University of Milan, Via Festa del Perdono 7, 20122, Milan, Italy. Electronic address: rossella.lavatelli@unimi.it.
  • Previtali R; University of Milan, Via Festa del Perdono 7, 20122, Milan, Italy. Electronic address: roberto.previtali@unimi.it.
  • Parenti L; Vittore Buzzi Children's Hospital, Pediatric Neurology Unit, Via Castelvetro, 32, 20154, Milan, Italy. Electronic address: laura.parenti@asst-fbf-sacco.it.
  • Fiori L; Vittore Buzzi Children's Hospital, Department of Pediatrics, Via Castelvetro, 32, 20154, Milan, Italy. Electronic address: laura.fiori@asst-fbf-sacco.it.
  • Dilillo D; Vittore Buzzi Children's Hospital, Department of Pediatrics, Via Castelvetro, 32, 20154, Milan, Italy. Electronic address: dario.dilillo@asst-fbf-sacco.it.
  • Zuccotti GV; Vittore Buzzi Children's Hospital, Department of Pediatrics, Via Castelvetro, 32, 20154, Milan, Italy; Department of Biomedical and Clinical Sciences, L. Sacco, University of Milan, Via Giovanni Battista Grassi, 74, 20157, Milan, Italy. Electronic address: gianvincenzo.zuccotti@unimi.it.
  • Veggiotti P; Vittore Buzzi Children's Hospital, Pediatric Neurology Unit, Via Castelvetro, 32, 20154, Milan, Italy; Department of Biomedical and Clinical Sciences, L. Sacco, University of Milan, Via Giovanni Battista Grassi, 74, 20157, Milan, Italy. Electronic address: pierangelo.veggiotti@unimi.it.
  • Bova SM; Vittore Buzzi Children's Hospital, Pediatric Neurology Unit, Via Castelvetro, 32, 20154, Milan, Italy. Electronic address: stefania.bova@asst-fbf-sacco.it.
Eur J Paediatr Neurol ; 34: 84-90, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1340639
ABSTRACT

OBJECTIVE:

To characterize neurological involvement in multisystem inflammatory syndrome in children (MIS-C) related to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.

METHODS:

Retrospective analysis of the clinical, electroencephalographic, CSF and neuroradiological parameters recorded in seven children (3 males, aged 3-10 years) affected by MIS-C with acute neurological involvement.

RESULTS:

All cases presented acute encephalopathy with drowsiness, irritability, mood deflection and diffuse EEG slowing with periodic posterior complexes. Focal neurological signs, normal brain MRI and CSF, were present in four patients; these patients received intravenous methylprednisolone at 30 mg/kg/day for 3 days. In all cases, the clinical picture rapidly improved in the first three days, and all neurological symptoms and EEG abnormalities disappeared within 10 and 30 days respectively. The severity and duration of the EEG abnormalities was proportional to the extent of the neurological involvement.

CONCLUSIONS:

Patients with MIS-C may present acute encephalitis characterized by rapid-onset encephalopathy and EEG abnormalities (slow wave activity and/or epileptic abnormalities), in some cases associated with focal neurological signs that disappear with immunomodulatory therapy. The detection through neurological evaluation of sentinel neurological signs and distinctive EEG patterns documentable at disease onset will allow timely diagnosis and treatment of these cases.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Encephalitis / COVID-19 Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study Topics: Long Covid Limits: Child / Humans / Male Language: English Journal: Eur J Paediatr Neurol Journal subject: Neurology / Pediatrics Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Encephalitis / COVID-19 Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study Topics: Long Covid Limits: Child / Humans / Male Language: English Journal: Eur J Paediatr Neurol Journal subject: Neurology / Pediatrics Year: 2021 Document Type: Article