SHM Converge Scientific Abstract ePoster Gallery-From Viral Infection to Neurological Crisis: A Case of Covid-19 Associated Encephalitis

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This case describes a 21-year-old previously healthy woman who developed acute encephalopathy, right-sided weakness, and aphasia after a recent COVID-19 infection. Her evaluation showed leukocytosis, elevated inflammatory markers, transaminitis, and elevated troponin, but infectious and toxicologic testing were otherwise negative.<br /><br />Brain CT angiography and perfusion imaging were normal, and lumbar puncture was unremarkable. However, MRI revealed abnormal left-sided white matter changes extending through the corpus callosum, suggesting a demyelinating or inflammatory process. EEG showed diffuse cerebral dysfunction. Based on the clinical picture and imaging, neurology suspected COVID-19-associated encephalitis or ADEM-like illness.<br /><br />She was treated with intravenous methylprednisolone (Solu-Medrol) for three days, with significant neurologic improvement. Follow-up MRI showed resolution of the abnormalities, and she was transitioned to dexamethasone before discharge. She was referred for follow-up with primary care, neurology, psychiatry, and physical therapy.<br /><br />The report emphasizes that COVID-19 can cause serious immune-mediated neurologic complications, even in young and otherwise healthy patients. It also highlights that normal lumbar puncture and vascular studies do not rule out inflammatory encephalitis or demyelination. MRI findings involving white matter and the corpus callosum can be key to diagnosis, and early corticosteroid treatment may lead to rapid recovery.

Asset Subtitle

Chidozie B. Igbonagwam

Meta Tag

Author List Adeeb Mustafa, Adrian Feliciano, Chidozie B. Igbonagwam, Christiane Martell, Jason Baluja, Vivan Loveday-Laghi

Category Clinical Vignettes

Concept COVID-19

Concept Encephalitis

Concept Acute disseminated encephalomyelitis

Concept Altered Mental Status

Concept Demyelination

Distinguished Non-Finalist

Presenter Organization Lakeland Regional Health

Presenting Author Chidozie B. Igbonagwam

Track Adult

Keywords

COVID-19

encephalitis

ADEM

demyelination

MRI white matter

corpus callosum

methylprednisolone

aphasia

acute encephalopathy

neurologic complications

COVID-19

Encephalitis

Acute disseminated encephalomyelitis

Altered Mental Status

Demyelination