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Post-infectious basal ganglia encephalitis and axonal variant of Guillain-Barré syndrome after COVID-19 infection: an atypical case report

  • Yang, Jiwon (Department of Neurology, Gil Medical Center, Gachon University College of Medicine) ;
  • Shin, Dong-Jin (Department of Neurology, Gil Medical Center, Gachon University College of Medicine) ;
  • Park, Hyeon-Mi (Department of Neurology, Gil Medical Center, Gachon University College of Medicine) ;
  • Lee, Yeong-Bae (Department of Neurology, Gil Medical Center, Gachon University College of Medicine) ;
  • Sung, Young-Hee (Department of Neurology, Gil Medical Center, Gachon University College of Medicine)
  • Received : 2022.07.19
  • Accepted : 2022.08.16
  • Published : 2022.10.30

Abstract

Neurological complications attributed to coronavirus disease-19 (COVID-19) infection have been reported including acute disseminated encephalomyelitis, Guillain-Barré syndrome, and so on. Herein, we report a 49-year-old woman presented with acute encephalopathy and paraplegia simultaneously after COVID-19 infection. Brain magnetic resonance imaging (MRI) showed symmetric hyperintense basal ganglia lesions on T2-weighted imaging. Cerebrospinal fluid pleocytosis, motor axonal neuropathy and enhancement of conus medullaris nerve roots on spine MRI were observed. We treated her with high-dose corticosteroid and intravenous immunoglobulin.

Keywords

References

  1. Ellul MA, Benjamin L, Singh B, Lant S, Michael BD, Easton A, et al. Neurological associations of COVID-19. Lancet Neurol 2020;19:767-783. https://doi.org/10.1016/S1474-4422(20)30221-0
  2. Palaiodimou L, Stefanou MI, Katsanos AH, Fragkou PC, Papadopoulou M, Moschovos C, et al. Prevalence, clinical characteristics and outcomes of Guillain-Barre syndrome spectrum associated with COVID-19: a systematic review and meta-analysis. Eur J Neurol 2021;28:3517-3529. https://doi.org/10.1111/ene.14860
  3. Siow I, Lee KS, Zhang JJY, Saffari SE, Ng A. Encephalitis as a neurological complication of COVID-19: a systematic review and meta-analysis of incidence, outcomes, and predictors. Eur J Neurol 2021;28:3491-3502. https://doi.org/10.1111/ene.14913
  4. Bertrand A, Leclercq D, Martinez-Almoyna L, Girard N, Stahl JP, De-Broucker T. MR imaging of adult acute infectious encephalitis. Med Mal Infect 2017;47:195-205. https://doi.org/10.1016/j.medmal.2017.01.002
  5. Pohl D, Alper G, Van Haren K, Kornberg AJ, Lucchinetti CF, Tenembaum S, et al. Acute disseminated encephalomyelitis: updates on an inflammatory CNS syndrome. Neurology 2016;87(9 Suppl 2):S38-S45. https://doi.org/10.1212/WNL.0000000000002825
  6. Gulko E, Oleksk ML, Gomes W, Ali S, Mehta H, Overby P, et al. MRI brain findings in 126 patients with COVID-19: initial observations from a descriptive literature review. AJNR Am J Neuroradiol 2020;41:2199-2203. https://doi.org/10.3174/ajnr.A6805
  7. Van Cauter S, Severino M, Ammendola R, Van Berkel B, Vavro H, van den Hauwe L, et al. Bilateral lesions of the basal ganglia and thalami (central grey matter)-pictorial review. Neuroradiology 2020;62:1565-1605. https://doi.org/10.1007/s00234-020-02511-y
  8. Werner R, Lohr B, Lodemann P, Chemnitz JM, Woehrle JC. Autoimmune basal ganglia encephalitis with hemolytic anemia. Ann Hematol 2022;101:1857-1858. https://doi.org/10.1007/s00277-022-04848-1
  9. Pawela C, Brunsdon RK, Williams TA, Porter M, Dale RC, Mohammad SS. The neuropsychological profile of children with basal ganglia encephalitis: a case series. Dev Med Child Neurol 2017;59:445-448. https://doi.org/10.1111/dmcn.13351
  10. Fokke C, van den Berg B, Drenthen J, Walgaard C, van Doorn PA, Jacobs BC. Diagnosis of Guillain-Barre syndrome and validation of Brighton criteria. Brain 2014;137(Pt 1):33-43. https://doi.org/10.1093/brain/awt285
  11. Wakerley BR, Yuki N. Mimics and chameleons in Guillain-Barre and Miller Fisher syndromes. Pract Neurol 2015;15:90-99. https://doi.org/10.1136/practneurol-2014-000937
  12. Yang J, Lee YB, Lee KW, Park HM. Atypical acute motor axonal neuropathy with cerebrospinal pleocytosis mimicking myelitis. J Clin Neurol 2017;13:205-206. https://doi.org/10.3988/jcn.2017.13.2.205