Steroid-Responsive Encephalitis in Coronavirus Disease 2019
Steroid-Responsive Encephalitis in Coronavirus Disease 2019
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DOI：
10.1002/ana.25783
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发表时间：
2020-06-09
影响因子：
11.2
通讯作者：
Padovani, Alessandro
中科院分区：
文献类型：
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作者：
Pilotto, Andrea;Odolini, Silvia;Padovani, Alessandro
2019冠状病毒病（COVID-19）感染有可能靶向中枢神经系统，严重呼吸窘迫患者中有几种神经系统症状。在这里，我们描述了一个60岁的患者，患有严重急性呼吸综合征冠状病毒2 （SARS-CoV-2）感染，但只有轻微的呼吸异常，他发展为脑炎引起的不动性缄默症。磁共振成像为阴性，而脑电图显示广泛性θ波减慢。急性期脑脊液分析SARS-CoV-2阴性，多细胞增多和高蛋白血症阳性，白细胞介素-8和肿瘤坏死因子- α浓度升高。排除其他感染性或自身免疫性疾病。在大剂量类固醇治疗后，观察到临床进展改善，脑脊液参数减少，因此认为炎症介导的脑受累与COVID-19有关。Ann neurol 2020
Coronavirus disease 2019 (COVID-19) infection has the potential for targeting the central nervous system, and several neurological symptoms have been described in patients with severe respiratory distress. Here, we described the case of a 60-year-old patient with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection but only mild respiratory abnormalities who developed an akinetic mutism attributable to encephalitis. Magnetic resonance imaging was negative, whereas electroencephalography showed generalized theta slowing. Cerebrospinal fluid analyses during the acute stage were negative for SARS-CoV-2, positive for pleocytosis and hyperproteinorrachia, and showed increased interleukin-8 and tumor necrosis factor-alpha concentrations. Other infectious or autoimmune disorders were excluded. A progressive clinical improvement along with a reduction of cerebrospinal fluid parameters was observed after high-dose steroid treatment, thus arguing for an inflammatory-mediated brain involvement related to COVID-19. ANN NEUROL 2020