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COVID-19-related encephalopathy: a case series with brain FDG-positron-emission tomography/computed tomography findings.
Delorme, C; Paccoud, O; Kas, A; Hesters, A; Bombois, S; Shambrook, P; Boullet, A; Doukhi, D; Le Guennec, L; Godefroy, N; Maatoug, R; Fossati, P; Millet, B; Navarro, V; Bruneteau, G; Demeret, S; Pourcher, V.
  • Delorme C; Department of Neurology, Sorbonne University, Assistance Publique des Hôpitaux de Paris (AP-HP), University Hospitals - Pitié-Salpêtrière Charles Foix, Paris, France.
  • Paccoud O; Department of Infectious and Tropical diseases, Sorbonne University, AP-HP, University Hospitals Pitié-Salpêtrière Charles Foix, Paris, France.
  • Kas A; Nuclear Medicine and LIB Department, Sorbonne University, AP-HP, University Hospitals Pitié-Salpêtrière Charles Foix, INSERM U1146, Paris, France.
  • Hesters A; Department of Neurology, Sorbonne University, Assistance Publique des Hôpitaux de Paris (AP-HP), University Hospitals - Pitié-Salpêtrière Charles Foix, Paris, France.
  • Bombois S; Department of Neurology, Sorbonne University, Assistance Publique des Hôpitaux de Paris (AP-HP), University Hospitals - Pitié-Salpêtrière Charles Foix, Paris, France.
  • Shambrook P; Department of Neurology, Sorbonne University, Assistance Publique des Hôpitaux de Paris (AP-HP), University Hospitals - Pitié-Salpêtrière Charles Foix, Paris, France.
  • Boullet A; Department of Neurology, Sorbonne University, Assistance Publique des Hôpitaux de Paris (AP-HP), University Hospitals - Pitié-Salpêtrière Charles Foix, Paris, France.
  • Doukhi D; Department of Neurology, Sorbonne University, Assistance Publique des Hôpitaux de Paris (AP-HP), University Hospitals - Pitié-Salpêtrière Charles Foix, Paris, France.
  • Le Guennec L; Department of Neurology, Sorbonne University, Assistance Publique des Hôpitaux de Paris (AP-HP), University Hospitals - Pitié-Salpêtrière Charles Foix, Paris, France.
  • Godefroy N; Department of Infectious and Tropical diseases, Sorbonne University, AP-HP, University Hospitals Pitié-Salpêtrière Charles Foix, Paris, France.
  • Maatoug R; Department of adult Psychiatry, Sorbonne University, AP-HP, University Hospitals Pitié-Salpêtrière Charles Foix, Paris, France.
  • Fossati P; Department of adult Psychiatry, Sorbonne University, AP-HP, University Hospitals Pitié-Salpêtrière Charles Foix, Paris, France.
  • Millet B; Department of adult Psychiatry, Sorbonne University, AP-HP, University Hospitals Pitié-Salpêtrière Charles Foix, Paris, France.
  • Navarro V; Department of Neurophysiology, Sorbonne University, AP-HP, University Hospitals Pitié-Salpêtrière Charles Foix, Paris, France.
  • Bruneteau G; Department of Neurology, Sorbonne University, Assistance Publique des Hôpitaux de Paris (AP-HP), University Hospitals - Pitié-Salpêtrière Charles Foix, Paris, France.
  • Demeret S; Department of Neurology, Sorbonne University, Assistance Publique des Hôpitaux de Paris (AP-HP), University Hospitals - Pitié-Salpêtrière Charles Foix, Paris, France.
  • Pourcher V; Department of Infectious and Tropical diseases, Sorbonne University, AP-HP, University Hospitals Pitié-Salpêtrière Charles Foix, Paris, France.
Eur J Neurol ; 27(12): 2651-2657, 2020 12.
Article in English | MEDLINE | ID: covidwho-799153
Semantic information from SemMedBD (by NLM)
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Impaired cognition
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Patients
2. COVID-19 PROCESS_OF Patients
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7. Status Epilepticus PROCESS_OF Patients
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Status Epilepticus
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Patients
8. Cerebellar Diseases PROCESS_OF Patients
Subject
Cerebellar Diseases
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9. Circumferential Supracrestal Fiberotomy AFFECTS Patients
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Patients
10. Cerebellum LOCATION_OF Hypermetabolism
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Cerebellum
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Hypermetabolism
11. Impaired cognition PROCESS_OF Patients
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Impaired cognition
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Patients
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Spinal Puncture
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ADMINISTERED_TO
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Patients
14. Screening procedure ADMINISTERED_TO Patients
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Screening procedure
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Patients
15. Nuclear magnetic resonance imaging brain ADMINISTERED_TO Patients
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Nuclear magnetic resonance imaging brain
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Patients
16. FDG-Positron Emission Tomography and Computed Tomography Scan ADMINISTERED_TO Patients
Subject
FDG-Positron Emission Tomography and Computed Tomography Scan
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ADMINISTERED_TO
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Patients
17. Status Epilepticus PROCESS_OF Patients
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Status Epilepticus
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PROCESS_OF
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Patients
18. Cerebellar Diseases PROCESS_OF Patients
Subject
Cerebellar Diseases
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PROCESS_OF
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Patients
19. Circumferential Supracrestal Fiberotomy AFFECTS Patients
Subject
Circumferential Supracrestal Fiberotomy
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AFFECTS
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Patients
20. Cerebellum LOCATION_OF Hypermetabolism
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Cerebellum
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ABSTRACT

AIM:

The aim of this paper is to describe the clinical features of COVID-19-related encephalopathy and their metabolic correlates using brain 2-desoxy-2-fluoro-D-glucose (FDG)-positron-emission tomography (PET)/computed tomography (CT) imaging. BACKGROUND AND

PURPOSE:

A variety of neurological manifestations have been reported in association with COVID-19. COVID-19-related encephalopathy has seldom been reported and studied.

METHODS:

We report four cases of COVID-19-related encephalopathy. The diagnosis was made in patients with confirmed COVID-19 who presented with new-onset cognitive disturbances, central focal neurological signs, or seizures. All patients underwent cognitive screening, brain magnetic resonance imaging (MRI), lumbar puncture, and brain 2-desoxy-2-fluoro-D-glucose (FDG)-positron-emission tomography (PET)/computed tomography (CT) (FDG-PET/CT).

RESULTS:

The four patients were aged 60 years or older, and presented with various degrees of cognitive impairment, with predominant frontal lobe impairment. Two patients presented with cerebellar syndrome, one patient had myoclonus, one had psychiatric manifestations, and one had status epilepticus. The delay between first COVID-19 symptoms and onset of neurological symptoms was between 0 and 12 days. None of the patients had MRI features of encephalitis nor significant cerebrospinal fluid (CSF) abnormalities. SARS-CoV-2 RT-PCR in the CSF was negative for all patients. All patients presented with a consistent brain FDG-PET/CT pattern of abnormalities, namely frontal hypometabolism and cerebellar hypermetabolism. All patients improved after immunotherapy.

CONCLUSIONS:

Despite varied clinical presentations, all patients presented with a consistent FDG-PET pattern, which may reflect an immune mechanism.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Brain Diseases / COVID-19 Type of study: Case report / Diagnostic study / Prognostic study / Qualitative research Topics: Long Covid / Variants Limits: Aged / Female / Humans / Male / Middle aged Language: English Journal: Eur J Neurol Journal subject: Neurology Year: 2020 Document Type: Article Affiliation country: Ene.14478

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Brain Diseases / COVID-19 Type of study: Case report / Diagnostic study / Prognostic study / Qualitative research Topics: Long Covid / Variants Limits: Aged / Female / Humans / Male / Middle aged Language: English Journal: Eur J Neurol Journal subject: Neurology Year: 2020 Document Type: Article Affiliation country: Ene.14478