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Acute Demyelinating Encephalomyelitis (ADEM) in COVID-19 Infection: A Case Series
Micheala McCuddy1, Praful Kelkar2, Yu Zhao2
1Department of Family Practice, Univ of Minnesota, Minneapolis, United States.
Neurology India
|October 28, 2020
Summary
Three COVID-19 patients developed acute demyelinating encephalomyelitis (ADEM), a neurological complication. While corticosteroids showed some benefit, two patients had minimal response, highlighting ADEM as a post-infectious complication of COVID-19.
Area of Science:
- Neurology
- Infectious Diseases
- Immunology
Background:
- COVID-19 infection can lead to severe respiratory distress.
- Neurological complications are increasingly recognized in COVID-19 patients.
- Acute demyelinating encephalomyelitis (ADEM) is a rare neurological condition.
Observation:
- Three patients with severe COVID-19 requiring intubation developed acute demyelinating encephalomyelitis (ADEM).
- Clinical presentation included unresponsiveness and severe weakness.
- MRI confirmed ADEM findings, with elevated CSF protein and normal cell counts.
Findings:
- Two male and one female patient, aged 38-63, presented with COVID-19 symptoms.
- All patients required ventilatory support due to acute respiratory distress syndrome.
- One patient showed significant improvement with intravenous corticosteroids; others had minimal response.
Implications:
- ADEM can occur as a postinfectious, immune-mediated complication of COVID-19.
- Corticosteroid therapy may be a potential treatment for COVID-19-associated ADEM.
- Further research is needed to understand the pathogenesis and optimal management of these neurological complications.
