17º CONGRESSO BRASILEIRO DE NEUROLOGIA INFANTIL

Dados do Trabalho


Título

SCHOLAR PATIENT WITH AUTOIMMUNE ENCEPHALITIS AFTER BEING INFECTED WITH SARSCOV2

Apresentação do caso

B,F,D, 6 years, women, previously healthy, initiated SARSCov2 symptoms with infection, fever, asthenia and recurrent vomit, signals of extrapyramidal release, ataxia, dysarthria and paraplegia. Evolving it to metabolic acidosis, flaccid quadriplegia and hospitalization at intensive care unit (ICU).
When investigating: serology’s and CSF with no alteration. Electrophysiological study with EEG and electroneuromyography keep normal. Nuclear magnetic resonance (NMR) image and angio-NMR of normal cranium. NMR from vertebral column without significantly changes. Received methylprednisolone 30(mg/kg/day) for 5 and 7 days of human immunoglobulin (IgH), gradually recovering from lower members and cervical tone. Keeping broca's aphasia and PCR positive SARSCov2 for seven more days.
Was discharged and initially following: Recovering from member’s mobilization, strength and cognition. Dystonia got worse after three months and new development regression. With good recovering from the signals and symptoms after IgH, fulfilling criteria for autoimmune encephalitis possibility. Being opted for monthly replacement from IgH with gain maintenance from neuropsychomotor development.

Discussão

The disease caused by the new Coronavirus (COVID19) mainly affects the respiratory system, with symptoms as: fever, dry cough, dyspnea and pneumonia, in addition to affect the gastrointestinal tract, the neurological system is one of the main affected by the disease. About one third of the patients have: feverish convulsions, convulsions and encephalitis, which can occur during the acute phase or after the infection. The virus can invade the Central Nervous System (CNS) thought the olfactory bulb causing inflammation and demyelination of neurons.

Comentários finais

Encephalopathy is one of the main manifestation from (CNS) in patients with severe conditions of COVID-19. The diagnostic from encephalopathy has been done clinically way since there are prodromal symptoms.
The clinical support associated to the corticosteroid immune modulating therapy with high doses and human immunoglobulin, shows benefits when limiting the systemic inflammatory answer caused by the virus, as in this related case, whereas observes an important recovery after those therapies.

Declaração de conflito de interesses de TODOS os autores

Não há conflito de interesse.

Área

Neuroinfecções

Instituições

Hospital Pequeno Príncipe - Paraná - Brasil

Autores

Rui Carlos Silva Júnior, Giulia Vilela Silva, Lorena Vilela Rezende, Mariah Pereira de Andrade Vallim, Izabela Cristina Macedo Marques, Shema El-Laden Hammoud, Ana Paula Resende Silva, Michelle Silva Zeny, Daniel Almeida do Valle