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COVID-19-related encephalopathy presenting with aphasia resolving following tocilizumab treatment.
Muccioli, Lorenzo; Pensato, Umberto; Cani, Ilaria; Guerra, Luca; Provini, Federica; Bordin, Giorgio; Riccioli, Luca Albini; Lodi, Raffaele; Tinuper, Paolo; Bisulli, Francesca.
  • Muccioli L; Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy.
  • Pensato U; Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy.
  • Cani I; Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy.
  • Guerra L; Infectious Diseases Unit, AOSP and AUSL Bologna, Bologna, Italy.
  • Provini F; Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy; IRCCS Istituto delle Scienze Neurologiche di Bologna, Full Member of the ERN EpiCARE, Bologna, Italy.
  • Bordin G; Piccole Figlie Hospital, Parma, Italy.
  • Riccioli LA; IRCCS Istituto delle Scienze Neurologiche di Bologna, Full Member of the ERN EpiCARE, Bologna, Italy.
  • Lodi R; Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy; IRCCS Istituto delle Scienze Neurologiche di Bologna, Full Member of the ERN EpiCARE, Bologna, Italy.
  • Tinuper P; Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy; IRCCS Istituto delle Scienze Neurologiche di Bologna, Full Member of the ERN EpiCARE, Bologna, Italy.
  • Bisulli F; Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy; IRCCS Istituto delle Scienze Neurologiche di Bologna, Full Member of the ERN EpiCARE, Bologna, Italy. Electronic address: francesca.bisulli@unibo.it.
J Neuroimmunol ; 349: 577400, 2020 12 15.
Article in English | MEDLINE | ID: covidwho-792960
Semantic information from SemMedBD (by NLM)
1. Analysis USES Circumferential Supracrestal Fiberotomy
Subject
Analysis
Predicate
USES
Object
Circumferential Supracrestal Fiberotomy
2. CNS metastases COEXISTS_WITH COVID-19
Subject
CNS metastases
Predicate
COEXISTS_WITH
Object
COVID-19
3. Encephalopathies MANIFESTATION_OF CNS metastases
Subject
Encephalopathies
Predicate
MANIFESTATION_OF
Object
CNS metastases
4. tocilizumab ASSOCIATED_WITH Encephalopathies
Subject
tocilizumab
Predicate
ASSOCIATED_WITH
Object
Encephalopathies
5. Analysis USES Circumferential Supracrestal Fiberotomy
Subject
Analysis
Predicate
USES
Object
Circumferential Supracrestal Fiberotomy
6. CNS metastases COEXISTS_WITH COVID-19
Subject
CNS metastases
Predicate
COEXISTS_WITH
Object
COVID-19
7. Encephalopathies MANIFESTATION_OF CNS metastases
Subject
Encephalopathies
Predicate
MANIFESTATION_OF
Object
CNS metastases
8. tocilizumab ASSOCIATED_WITH Encephalopathies
Subject
tocilizumab
Predicate
ASSOCIATED_WITH
Object
Encephalopathies
ABSTRACT
Encephalopathy is emerging as a recurrent complication of COVID-19 yet remains poorly characterized. We report the case of a middle-aged woman with COVID-19-related encephalopathy presenting as expressive aphasia and inattentiveness, subsequently progressing to agitation and marked confusion. Brain MRI and CSF analysis were unremarkable, while EEG showed slowing with frontal sharp waves. Neuropsychiatric symptoms resolved following treatment with tocilizumab. CNS involvement in COVID-19 may present as a subacute encephalopathy characterized by prominent frontal lobe dysfunction, with language disturbances as first neurological manifestation. Future studies should further investigate the role of tocilizumab in treating COVID-19-related encephalopathy.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Aphasia / Brain Diseases / Antibodies, Monoclonal, Humanized / Cytokine Release Syndrome / COVID-19 Type of study: Case report Topics: Long Covid Limits: Female / Humans / Middle aged Language: English Journal: J Neuroimmunol Year: 2020 Document Type: Article Affiliation country: J.jneuroim.2020.577400

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Aphasia / Brain Diseases / Antibodies, Monoclonal, Humanized / Cytokine Release Syndrome / COVID-19 Type of study: Case report Topics: Long Covid Limits: Female / Humans / Middle aged Language: English Journal: J Neuroimmunol Year: 2020 Document Type: Article Affiliation country: J.jneuroim.2020.577400