CC BY 4.0 · Arq Neuropsiquiatr 2023; 81(S 01): S1-S96
DOI: 10.1055/s-0043-1774633
CASE REPORT
Neuroinfecções
Code: PE192

Scholar patient with autoimmune encephalitis after being infected with SARSCov2

Rui Carlos Silva Júnior
1   Hospital Pequeno Príncipe, Curitiba PR, Brazil
,
Giulia Vilela Silva
1   Hospital Pequeno Príncipe, Curitiba PR, Brazil
,
Lorena Vilela Rezende
1   Hospital Pequeno Príncipe, Curitiba PR, Brazil
,
Mariah Pereira de Andrade Vallim
1   Hospital Pequeno Príncipe, Curitiba PR, Brazil
,
Izabela Cristina Macedo Marques
1   Hospital Pequeno Príncipe, Curitiba PR, Brazil
,
Shema El-Laden Hammoud
1   Hospital Pequeno Príncipe, Curitiba PR, Brazil
,
Ana Paula Resende Silva
1   Hospital Pequeno Príncipe, Curitiba PR, Brazil
,
Michelle Silva Zeny
1   Hospital Pequeno Príncipe, Curitiba PR, Brazil
,
Daniel Almeida do Valle
1   Hospital Pequeno Príncipe, Curitiba PR, Brazil
› Author Affiliations
 

    Case presentation: B,F,D, 6 years, female, previously healthy, initiated SARSCov2 symptoms with infection, fever, asthenia and recurrent vomiting, signals of extrapyramidal release, ataxia, dysarthria and paraplegia. These symptoms evolved to metabolic acidosis, flaccid quadriplegia and hospitalization at intensive care unit (ICU). When investigating, serology's and CSF with no alteration. Electrophysiological studies were made with EEG and electroneuromyography, and the results were normal. Nuclear magnetic resonance (NMR) image and angio-NMR of normal cranium. NMR from vertebral column without significantly changes. Received methylprednisolone 30(mg/kg/day) for 5 and 7 days of human immunoglobulin (IgH), gradually recovering from lower members and cervical tone. Keeping broca's aphasia and PCR positive SARSCov2 for seven more days. Was discharged and initially following: Recovering from member's mobilization, strength and cognition. Dystonia got worse after three months and new development regression. With good recovering from the signals and symptoms after IgH, fulfilling criteria for autoimmune encephalitis possibility. Being opted for monthly replacement from IgH with gain maintenance from neuropsychomotor development.

    Discussion: The disease caused by the new Coronavirus (COVID19) mainly affects the respiratory system, with symptoms as: fever, dry cough, dyspnea and pneumonia, in addition to affect the gastrointestinal tract, the neurological system is one of the main affected by the disease. About one third of the patients have: feverish convulsions, convulsions and encephalitis, which can occur during the acute phase or after the infection. The virus can invade the Central Nervous System (CNS) thought the olfactory bulb causing inflammation and demyelination of neurons.

    Final comments: Encephalopathy is one of the main manifestations from (CNS) in patients with severe conditions of COVID-19. The diagnostic from encephalopathy has been done clinically way since there are prodromal symptoms. The clinical support associated to the corticosteroid immune modulating therapy with high doses and human immunoglobulin, shows benefits when limiting the systemic inflammatory answer caused by the virus, as in this related case, whereas observes an important recovery after those therapies.


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    No conflict of interest has been declared by the author(s).

    Publication History

    Article published online:
    18 September 2023

    © 2023. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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