Clinical and radiological features of severe acute respiratory syndrome coronavirus 2 meningo-encephalitis

• Published in: European journal of neurology Vol. 28; no. 10; pp. 3530 - 3532
• Main Authors: de Freitas, Gabriel R, Figueiredo, Marcos Ravi, Vianna, Arthur, Brandão, Carlos Otávio, Torres-Filho, Helio M, Martins, Andrea F A, Tovar-Moll, Fernanda, Barroso, Paulo F
• Format: Report
• Language: English
• Published: 01-10-2021
• ISSN: 1468-1331
• DOI: 10.1111/ene.14687

BACKGROUND AND PURPOSEThis case illustrates for the first time the clinical and radiological evolution of SARS-CoV-2 meningo-encephalitis. METHODSA case of a SARS-CoV-2 meningo-encephalitis is reported. RESULTSA 65-year-old man with COVID-19 presenting with meningo-encephalitis without respiratory involvement is described. He had fever, diarrhea and vomiting, followed by diplopia, urinary retention and sleepiness. Examination disclosed a convergence strabismus and ataxia. Cerebrospinal fluid (CSF) showed lymphocytic pleocytosis, oligoclonal bands and increased interleukin 6 level. SARS-CoV-2 was detected in the CSF through reverse transcriptase polymerase chain reaction, but not in nasopharyngeal, tracheal secretion and rectal samples. Brain magnetic resonance imaging showed lesions on white matter hemispheres, the body and splenium of the corpus callosum and resembling the projection of corticospinal tract, remarkably on cerebellar peduncles. CONCLUSIONSThis demonstrates the challenges in diagnosing COVID-19 in patients with neurological presentations.