Comparison between SARS-CoV-2-Associated Acute Disseminated Encephalomyelitis and Acute Stroke: A Case Report

Area of Science:

• Neurology
• Infectious Diseases
• Neuroimmunology

Background:

• Neurological manifestations of SARS-CoV-2 infection are increasingly recognized but remain understudied.
• While thrombotic events like ischemic stroke are documented, other neurological complications require further investigation.
• Acute disseminated encephalomyelitis (ADEM) is a rare but potential neurological complication of COVID-19.

Observation:

• A patient with SARS-CoV-2 infection presented with atypical neurological symptoms mimicking acute stroke, including hemiparesis, hemiparesthesia, and dysarthria.
• These stroke-like symptoms were attributed to COVID-19-associated Acute Disseminated Encephalomyelitis (ADEM).
• The case underscores the diagnostic challenge in differentiating COVID-19-associated ADEM from acute stroke due to overlapping clinical presentations.

Findings:

• COVID-19-associated ADEM can present with stroke-like neurological deficits, necessitating careful differential diagnosis.
• Distinguishing ADEM from acute stroke is critical as their treatment strategies differ significantly.
• Early identification and prompt management of COVID-19-associated ADEM are crucial to prevent severe outcomes.

Implications:

• Physicians should maintain a high index of suspicion for ADEM in SARS-CoV-2 infected patients presenting with neurological deficits.
• Increased awareness and reporting of COVID-19-associated ADEM cases are needed to clarify its incidence and clinical spectrum.
• This case contributes to understanding the diverse neurological spectrum of COVID-19 and informs clinical management strategies.