Vandervorst Fenne, Guldolf Kaat, Peeters Ilse, Vanderhasselt Tim, Michiels Kathleen, Berends Kinge Johanna, Van Laethem Johan, Pipeleers Lissa, Vincken Stefanie, Seynaeve Laura, Engelborghs Sebastiaan
Department of Neurology, UZ Brussel and Center for Neurosciences (C4N), Vrije Universiteit Brussel, Belgium.
Department of Radiology, UZ Brussel, Vrije Universiteit Brussel, Belgium.
Interdiscip Neurosurg. 2020 Dec;22:100821. doi: 10.1016/j.inat.2020.100821. Epub 2020 Jul 10.
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) usually causes fever, respiratory symptoms, malaise and myalgia. Recent observations suggested possible neurological complications of COVID-19, including the first report of suspected viral encephalitis. We report a case of a 29-year-old male with -on nasopharyngeal testing- confirmed SARS-CoV-2 infection with severe respiratory symptoms, followed by clinical and radiological signs of encephalitis. Magnetic resonance imaging (MRI) of the brain showed an asymmetric FLAIR-hyperintensity of the left medial temporal cortex associated with mild gyral expansion. Lumbar puncture was normal and PCR's for SARS-CoV-2 virus on CSF were negative. Clinicians treating SARS-CoV-2 infected patients should be aware of possible neurological complications, like encephalitis. The diagnosis of SARS-CoV-2 encephalitis is difficult as CSF analysis may be normal.
严重急性呼吸综合征冠状病毒2（SARS-CoV-2）通常会引起发热、呼吸道症状、不适和肌痛。最近的观察结果提示2019冠状病毒病（COVID-19）可能存在神经系统并发症，包括首例疑似病毒性脑炎的报告。我们报告了一例29岁男性病例，经鼻咽检测确诊为SARS-CoV-2感染，伴有严重呼吸道症状，随后出现脑炎的临床和影像学体征。脑部磁共振成像（MRI）显示左侧颞叶内侧皮质不对称的液体衰减反转恢复序列（FLAIR）高信号，伴有轻度脑回增宽。腰椎穿刺结果正常，脑脊液中SARS-CoV-2病毒的聚合酶链反应（PCR）检测为阴性。治疗SARS-CoV-2感染患者的临床医生应意识到可能出现的神经系统并发症，如脑炎。由于脑脊液分析可能正常，SARS-CoV-2脑炎的诊断较为困难。
