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Title: Acute Disseminated Encephalomyelitis in COVID-19: presentation of two cases and review of the literature
Authors: LOPES, Cesar Castello BrancoBRUCKI, Sonia Maria DozziPASSOS NETO, Carlos Eduardo BorgesCORAZZA, Luiza AlvesBAIMA, Jose Pedro SoaresFIORENTINO, Matheus DalbenTATSCH, Joao Fellipe SantosMARTIN, Maria da Graca MoraisLUCATO, Leandro TavaresGOMES, Helio RodriguesROCHA, Maria Sheila GuimaraesFORTINI, IdaNITRINI, RicardoCASTRO, Luiz H.
Citation: ARQUIVOS DE NEURO-PSIQUIATRIA, v.78, n.12, p.805-810, 2020
Abstract: Background: Neurological manifestations of COVID-19 are still incompletely understood. Neurological manifestations may be due to direct viral effect on neurons and glial cells, to an immune-mediated response to the virus, or to a hypercoagulable state and associated endothelial damage, as well as to severe systemic disease with prolonged intensive care unit stay. Objective: To describe two patients with severe SARS-CoV-2 infection and delayed recovery of consciousness after sedation withdrawal, in whom MRI disclosed multifocal white matter brain lesions, compatible with the diagnosis of acute disseminated encephalomyelitis. Methods: Observational report of two cases of severe COVID-19 infection in patients from two tertiary hospitals in Sao Paulo, Brazil. Results: These patients underwent neurologic and systemic evaluation for delayed awakening after sedation withdrawal. MRI displayed multifocal centrum semiovale lesions, suggestive of demyelinating inflammation. Cerebrospinal fluid (CSF) polymerase chain reaction (PCR) for SARS-CoV-2 was negative in both cases. Conclusion: A recurrent pattern of multifocal white matter lesions can occur in COVID-19 patients, possibly associated with delayed awakening. Additional studies are necessary to elucidate the role of the viral infection and of inflammatory and immune-mediated associated changes in neurological manifestations of COVID-19.
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Artigos e Materiais de Revistas Científicas - COVID-19

Artigos e Materiais de Revistas Científicas - FM/MNE
Departamento de Neurologia - FM/MNE

Artigos e Materiais de Revistas Científicas - HC/ICESP
Instituto do Câncer do Estado de São Paulo - HC/ICESP

Artigos e Materiais de Revistas Científicas - HC/ICHC
Instituto Central - HC/ICHC

Artigos e Materiais de Revistas Científicas - HC/InRad
Instituto de Radiologia - HC/InRad

Artigos e Materiais de Revistas Científicas - LIM/15
LIM/15 - Laboratório de Investigação em Neurologia

Artigos e Materiais de Revistas Científicas - LIM/44
LIM/44 - Laboratório de Ressonância Magnética em Neurorradiologia

Artigos e Materiais de Revistas Científicas - LIM/45
LIM/45 - Laboratório de Fisiopatologia Neurocirúrgica

Artigos e Materiais de Revistas Científicas - ODS/03
ODS/03 - Saúde e bem-estar

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