Acute neurological symptoms in multisystem inflammatory syndrome in children: A case series

Severe acute respiratory syndrome coronavirus-2 infection mostly involves pediatrics lesser than adults; however, the multisystem inflammatory syndrome in children is shown to be the following condition in children infected with SARS-CoV-2, even asymptomatic ones. To date, there is few evidence of the association of multisystem inflammatory syndrome in children with acute neurological symptoms.

This case series was recorded demographic, clinical, laboratory, radiographic and EEG data of patients with the multisystem inflammatory syndrome in children who diagnosed simultaneously with acute neurological symptoms. Children with the multisystem inflammatory syndrome in children and evidence of central nervous system involvements participated in the study. Data are reported as median (interquartile ranges) for quantitative data without normal distributions. The present study was conducted at the children's referral hospital of Isfahan province, Iran between March 1, 2020, and December 28, 2021. Simultaneous diagnosis of multisystem inflammatory syndrome in children and acute neurological symptoms was made in 12 children. The median age of patients was 4.5 years (10-144 months). The most common symptoms were seizures (58%). Cerebrospinal fluid analysis showed that only one patient had pleocytosis. In addition, one patient had a low glucose level. Finally, 11 patients were discharged in good condition and one patient died after full recovery from acute neurological symptoms due to her underlying disease.

According to our series and other studies, children with MIS-C may present signs and symptoms of acute neurological symptoms. Although its pathophysiology is unclear, studies showed that immunomodulatory agents, i.e., intravenous immunoglobulins and corticosteroids, provide a relatively good prognosis.