Early reversible leukoencephalopathy and unilateral sixth cranial nerve palsy in mild COVID-19 infection.
Neurol Sci
; 42(12): 4899-4902, 2021 Dec.
Article
in English
| MEDLINE | ID: covidwho-1391891
ABSTRACT
OBJECTIVES:
To provide new insights into neurological manifestations of COVID-19. We describe a patient with mild COVID-19 associated with diplopia from right sixth cranial nerve palsy and early diffuse leukoencephalopathy, successfully treated with intravenous methylprednisolone.METHODS:
The patient was evaluated for diplopia that occurred 1 day after the onset of fever, myalgia, and headache. A complete neurological workup, including neurological examination, cerebrospinal fluid (CSF) analysis with viral polymerase chain reaction (PCR), serum autoimmune encephalitis, and anti-nerve antibodies and brain magnetic resonance imaging (MRI), was performed.RESULTS:
Clinical examination revealed incomplete right sixth cranial nerve palsy. Brain MRI showed diffuse confluent fluid-attenuated inversion recovery (FLAIR) hyperintense white matter abnormalities, while CSF analysis showed mild hyperproteinorrachia (61 mg/dL) without pleocytosis. The patients were treated with high-dose intravenous methylprednisolone with rapid improvement of neurological symptoms and resolution of CSF and MRI abnormalities.DISCUSSION:
Our report shows that COVID-19 may predominantly present with neurological symptoms; furthermore, it argues the notion of leukoencephalopathy as a typical feature of a severe case of the disease. Mechanisms underpinning neurological symptoms in COVID-19 still need to be elucidated; nonetheless, early recognition and prompt management may ensure their improvement or even complete recovery and are therefore recommended.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Abducens Nerve Diseases
/
Leukoencephalopathies
/
COVID-19
Type of study:
Case report
/
Experimental Studies
/
Prognostic study
Limits:
Humans
Language:
English
Journal:
Neurol Sci
Journal subject:
Neurology
Year:
2021
Document Type:
Article
Affiliation country:
S10072-021-05545-z
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