Complex movement disorders in SARS-CoV-2 infection induced acute disseminated encephalomyelitis

Area of Science:

• Neurology
• Infectious Diseases
• Neuroimmunology

Background:

• Acute disseminated encephalomyelitis (ADEM) is a rare autoimmune neurological condition.
• Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can present with diverse neurological manifestations.
• Movement disorders are exceptionally uncommon in both ADEM and SARS-CoV-2 infection.

Observation:

• A previously healthy 34-year-old woman developed a febrile illness.
• She presented with a prominent constellation of movement disorders, primarily myoclonus, followed by encephalopathy.
• Standard infectious, autoimmune, and paraneoplastic causes were excluded.

Findings:

• The patient was diagnosed with ADEM triggered by COVID-19.
• Neurological symptoms, including movement disorders, preceded the diagnosis of ADEM.
• Treatment with intravenous methylprednisolone and immunoglobulin led to clinical improvement.

Implications:

• This case expands the understanding of rare neurological complications associated with SARS-CoV-2.
• It underscores the possibility of movement disorders preceding ADEM in post-COVID-19 scenarios.
• Highlights the importance of considering COVID-19 as an etiology for ADEM presenting with unusual initial symptoms.