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COVID-19-associated familial acute disseminated encephalomyelitis (ADEM): A case report

Sivaram Neppala1, Dinesh Kumar Sundarakumar2, Joseph W Caravella1

  • 1Department of Inte\rnal Medicine, University of Incarnate Word at Laredo Medical Center, Laredo, TX, 78041 USA.

Idcases
|September 6, 2021
PubMed
Abstract

Insights

This case report details a father and son with severe COVID-19 who developed Acute Disseminated Encephalomyelitis (ADEM). Their neurological outcomes varied, highlighting the unpredictable impact of COVID-19 on the central nervous system.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Immunology

Background:

  • Severe COVID-19 infections can lead to neurological complications, potentially from direct viral invasion or immune responses.
  • Acute disseminated encephalomyelitis (ADEM) is a rare inflammatory demyelinating CNS disorder typically following infection or vaccination.
  • Few ADEM cases linked to COVID-19 have been documented.

Observation:

  • A father and son hospitalized with severe COVID-19 presented with fever and respiratory distress.
  • Both developed neurological symptoms, including upper motor neuron signs, approximately 30 days post-admission.
  • Brain MRI revealed findings consistent with ADEM in both patients.

Findings:

  • Familial ADEM associated with severe COVID-19 infection was observed in a father and son.
  • Treatment with intravenous methylprednisolone yielded variable neurological outcomes.
  • The son experienced significant neurological deficits and MRI changes, while the father had better neurological recovery despite pulmonary complications.

Implications:

  • This is the first reported instance of ADEM in a father-son pair with severe COVID-19.
  • Neurological outcomes in COVID-19-associated ADEM appear correlated with overall disease severity.
  • Further research is crucial to optimize ADEM management in severe COVID-19 patients.

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