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A case of possible atypical demyelinating event of the central nervous system following COVID-19.
Mult Scler Relat Disord. 2020 Jun 24; 44:102324.MS

Abstract

After the novel coronavirus disease outbreak first began in Wuhan, China, in December 2019, the viral epidemic has quickly spread across the world, and it is now a major public health concern. Here we present a 21-year-old male with encephalomyelitis following intermittent vomiting and malaise for 4 days. He reported upper respiratory signs and symptoms 2 weeks before this presentation. Two cerebrospinal fluid (CSF) analyses were notable for mononuclear pleocytosis, elevated protein (more than 100 mg/dl), and hypoglycorrhachia. Brain Magnetic Resonance Imaging (MRI) showed bilateral posterior internal capsule lesions extending to the ventral portion of the pons and a marbled splenium hyperintensity pattern. Cervical and thoracic MRI showed longitudinally extensive transverse myelitis (LETM), none of which were enhanced with gadolinium. Both the AQP4 and MOG antibodies were negative. Spiral chest computed tomography (CT) scan confirmed to COVID-19 as did the high IgG level against coronavirus, but the oropharyngeal swabs were negative. Neurological manifestations of COVID-19 have not been adequately studied. Some COVID-19 patients, especially those suffering from a severe disease, are highly likely to have central nervous system (CNS) manifestations. Our case is a post-COVID-19 demyelinating event in the CNS.

Authors+Show Affiliations

Assistant professor of Neurology, Skull Base research center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.Assistant professor of Neurology, Skull Base research center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Electronic address: drramezani23@gmail.com.Resident of Neurology, Brain Mapping Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.Assistant professor of Infectious disease, Infectious Diseases and Tropical Research Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.Professor of Neurology, Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.

Pub Type(s)

Case Reports

Language

eng

PubMed ID

32615528

Citation

Zoghi, Anahita, et al. "A Case of Possible Atypical Demyelinating Event of the Central Nervous System Following COVID-19." Multiple Sclerosis and Related Disorders, vol. 44, 2020, p. 102324.
Zoghi A, Ramezani M, Roozbeh M, et al. A case of possible atypical demyelinating event of the central nervous system following COVID-19. Mult Scler Relat Disord. 2020;44:102324.
Zoghi, A., Ramezani, M., Roozbeh, M., Darazam, I. A., & Sahraian, M. A. (2020). A case of possible atypical demyelinating event of the central nervous system following COVID-19. Multiple Sclerosis and Related Disorders, 44, 102324. https://doi.org/10.1016/j.msard.2020.102324
Zoghi A, et al. A Case of Possible Atypical Demyelinating Event of the Central Nervous System Following COVID-19. Mult Scler Relat Disord. 2020 Jun 24;44:102324. PubMed PMID: 32615528.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A case of possible atypical demyelinating event of the central nervous system following COVID-19. AU - Zoghi,Anahita, AU - Ramezani,Mahtab, AU - Roozbeh,Mehrdad, AU - Darazam,Ilad Alavi, AU - Sahraian,Mohammad Ali, Y1 - 2020/06/24/ PY - 2020/05/06/received PY - 2020/06/08/revised PY - 2020/06/21/accepted PY - 2020/7/3/pubmed PY - 2020/7/3/medline PY - 2020/7/3/entrez KW - ADEM KW - COVID-19 KW - Demyelinating event KW - NMOSD SP - 102324 EP - 102324 JF - Multiple sclerosis and related disorders JO - Mult Scler Relat Disord VL - 44 N2 - After the novel coronavirus disease outbreak first began in Wuhan, China, in December 2019, the viral epidemic has quickly spread across the world, and it is now a major public health concern. Here we present a 21-year-old male with encephalomyelitis following intermittent vomiting and malaise for 4 days. He reported upper respiratory signs and symptoms 2 weeks before this presentation. Two cerebrospinal fluid (CSF) analyses were notable for mononuclear pleocytosis, elevated protein (more than 100 mg/dl), and hypoglycorrhachia. Brain Magnetic Resonance Imaging (MRI) showed bilateral posterior internal capsule lesions extending to the ventral portion of the pons and a marbled splenium hyperintensity pattern. Cervical and thoracic MRI showed longitudinally extensive transverse myelitis (LETM), none of which were enhanced with gadolinium. Both the AQP4 and MOG antibodies were negative. Spiral chest computed tomography (CT) scan confirmed to COVID-19 as did the high IgG level against coronavirus, but the oropharyngeal swabs were negative. Neurological manifestations of COVID-19 have not been adequately studied. Some COVID-19 patients, especially those suffering from a severe disease, are highly likely to have central nervous system (CNS) manifestations. Our case is a post-COVID-19 demyelinating event in the CNS. SN - 2211-0356 UR - https://www.unboundmedicine.com/medline/citation/32615528/A_case_of_possible_atypical_demyelinating_event_of_the_central_nervous_system_following_COVID-19 L2 - https://linkinghub.elsevier.com/retrieve/pii/S2211-0348(20)30400-4 DB - PRIME DP - Unbound Medicine ER -
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