Download PDF
Journal of Pediatric Neurology 2022; 20(05): 355-358
DOI: 10.1055/s-0042-1747964
Case Report

Acute Disseminated Encephalomyelitis with Prefrontal Cortex Involvement in a 9-Year-Old Child after COVID-19 Infection: A Case Report

Ayse Özlem Balik 
1   Radiology Department, Haydarpasa Training and Research Hospital, Istanbul, Turkey
,
Esra Gurdal Kosem
1   Radiology Department, Haydarpasa Training and Research Hospital, Istanbul, Turkey
› Author Affiliations
› Further Information
Also available at
    Permissions and Reprints

Abstract

The aim of the study was to present the rare co-occurring radiological findings of a child presenting with acute disseminated encephalomyelitis (ADEM) with a spinal cord and prefrontal cortex involvement after coronavirus disease 2019 (COVID-19) illness. The patient, who had COVID-19 a few weeks earlier, presented with progressive weakness in the right upper and lower extremities. Neurological examination of the patient was performed, and cranial magnetic resonance imaging (MRI) was taken on the same day. Serum severe acute respiratory syndrome coronavirus immunoglobulin M antibody testing was positive. MRI of the brain parenchyma and thoracic spine revealed fluid-attenuated inversion recovery and T2-weighted hyperintense lesions. Additionally, mild contrast enhancement was observed in both the prefrontal cortexes. The patient was discharged 10 days later with complete clinical recovery. Unlike other post-COVID-19 ADEM cases presenting in the literature, prefrontal cortex involvement makes our case rare.

Keywords

encephalomyelitis - acute disseminated - COVID-19 - prefrontal cortex


Publication History

Received: 12 November 2021

Accepted: 09 March 2022

Article published online:
11 July 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Sarbu N, Shih RY, Jones RV, Horkayne-Szakaly I, Oleaga L, Smirniotopoulos JG. White matter diseases with radiologic-pathologic correlation. Radiographics 2016; 36 (05) 1426-1447
    CrossrefPubMedGoogle Scholar
  • 2 Tenembaum SN. Acute disseminated encephalomyelitis. Handb Clin Neurol 2013; 112: 1253-1262
    CrossrefPubMedGoogle Scholar
  • 3 Krupp LB, Banwell B, Tenembaum S. International Pediatric MS Study Group. Consensus definitions proposed for pediatric multiple sclerosis and related disorders. Neurology 2007; 68: 7-12
    CrossrefPubMedGoogle Scholar
  • 4 Dale RC, de Sousa C, Chong WK, Cox TC, Harding B, Neville BG. Acute disseminated encephalomyelitis, multiphasic disseminated encephalomyelitis and multiple sclerosis in children. Brain 2000; 123 (Pt 12): 2407-2422
    CrossrefPubMedGoogle Scholar
  • 5 Manzano GS, McEntire CRS, Martinez-Lage M, Mateen FJ, Hutto SK. Acute disseminated encephalomyelitis and acute hemorrhagic leukoencephalitis following COVID-19. Neurol Neuroimmunol Neuroinflamm 2021; 8 (06) 8
    CrossrefPubMedGoogle Scholar
  • 6 Callen DJA, Shroff MM, Branson HM. et al. Role of MRI in the differentiation of ADEM from MS in children. Neurology 2009; 72 (11) 968-973
    CrossrefPubMedGoogle Scholar
  • 7 Thompson AJ, Banwell BL, Barkhof F. et al. Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria. Lancet Neurol 2018; 17 (02) 162-173
    CrossrefPubMedGoogle Scholar
  • 8 Lindan CE, Mankad K, Ram D. et al; ASPNR PECOBIG Collaborator Group. Neuroimaging manifestations in children with SARS-CoV-2 infection: a multinational, multicentre collaborative study. Lancet Child Adolesc Health 2021; 5 (03) 167-177
    CrossrefPubMedGoogle Scholar
  • 9 Chiotos K, Bassiri H, Behrens EM. et al. Multisystem inflammatory syndrome in children during the COVID-19 pandemic: a case series. J Pediatric Infect Dis Soc 2020; 9 (03) 393-398
    CrossrefPubMedGoogle Scholar
  • 10 Dahm T, Rudolph H, Schwerk C, Schroten H, Tenenbaum T. Neuroinvasion and inflammation in viral central nervous system infections. Mediators Inflamm 2016; 2016: 8562805
    CrossrefPubMedGoogle Scholar
  • 11 Desforges M, Le Coupanec A, Stodola JK, Meessen-Pinard M, Talbot PJ. Human coronaviruses: viral and cellular factors involved in neuroinvasiveness and neuropathogenesis. Virus Res 2014; 194: 145-158
    CrossrefPubMedGoogle Scholar
  • 12 Chen TH. Neurological involvement associated with COVID-19 infection in children. J Neurol Sci 2020; 418: 117096
    CrossrefPubMedGoogle Scholar
  • 13 Politi LS, Salsano E, Grimaldi M. Magnetic resonance imaging alteration of the brain in a patient with coronavirus disease 2019 (COVID-19) and anosmia. JAMA Neurol 2020; 77 (08) 1028-1029
    CrossrefPubMedGoogle Scholar
  • 14 Aragão MFVV, Leal MC, Cartaxo Filho OQ, Fonseca TM, Valença MM. Anosmia in COVID-19 associated with injury to the olfactory bulbs evident on MRI. AJNR Am J Neuroradiol 2020; 41 (09) 1703-1706
    PubMedGoogle Scholar
  • 15 Yeh EA, Collins A, Cohen ME, Duffner PK, Faden H. Detection of coronavirus in the central nervous system of a child with acute disseminated encephalomyelitis. Pediatrics 2004; 113 (1 Pt 1): e73-e76
    CrossrefPubMedGoogle Scholar
  • 16 Zubair AS, McAlpine LS, Gardin T, Farhadian S, Kuruvilla DE, Spudich S. Neuropathogenesis and neurologic manifestations of the coronaviruses in the age of coronavirus disease a review. JAMA Neurol 2020; 77 (08) 1018-1027
    CrossrefPubMedGoogle Scholar
  • 17 Lin E, Lantos JE, Strauss SB. et al. Brain imaging of patients with COVID-19: findings at an academic institution during the height of the outbreak in New York City. Am J Neuroradiol 2020; 41 (11) 2001-2008
    CrossrefPubMedGoogle Scholar