Post-infectious focal encephalitis due to COVID-19

Area of Science:

• Neurology
• Infectious Diseases
• Immunology

Background:

• Neurological manifestations of SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) are increasingly reported.
• Immune-mediated neurological damage is a recognized complication of COVID-19.

Observation:

• A young male presented with new-onset seizures and severe headache in early 2020.
• Brain MRI revealed a left frontal lesion; SARS-CoV-2 nasal PCR was negative, but serology was positive.
• Cerebrospinal fluid showed elevated immunoglobulin G with oligoclonal bands.

Findings:

• The patient received IV immunoglobulin therapy, leading to headache improvement.
• Follow-up brain MRIs demonstrated complete resolution of the frontal lesion.
• The clinical presentation and MRI findings strongly suggest immune-mediated encephalitis post-SARS-CoV-2 exposure.

Implications:

• This case supports immune-mediated encephalitis as a potential neurological complication of COVID-19.
• Understanding these immune responses is crucial for managing neurological sequelae of SARS-CoV-2 infection.
• Early recognition and treatment of immune-mediated encephalitis may lead to favorable patient outcomes.