Cooper Neurological Institute, Cooper University Hospital, and Cooper Medical School of Rowan University, Camden, NJ 08103, United States.
Department of Radiology, Cooper University Hospital, Camden, NJ 08103, United States.
J Clin Neurosci. 2020 Sep;79:272-274. doi: 10.1016/j.jocn.2020.07.009. Epub 2020 Jul 7.
Neurological complications of coronavirus 2019 (COVID-19) are common, and novel manifestations are increasingly being recognized. Mild encephalopathy with reversible splenium lesion (MERS) is a syndrome that has been associated with viral infections, but not previously with COVID-19. In this report, we describe the case of a 69 year-old man who presented with fever and encephalopathy in the setting of a diffusion-restricting splenium lesion, initially mimicking an ischemic stroke. A comprehensive infectious workup revealed positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies, and a pro-inflammatory laboratory profile characteristic of COVID-19 infection. His symptoms resolved and the brain MRI findings completely normalized on repeat imaging, consistent with MERS. This case suggests that MERS may manifest as an autoimmune response to SARS-CoV-2 infection and should be considered in a patient with evidence of recent COVID-19 infection and the characteristic MERS clinico-radiological syndrome.
新型冠状病毒（COVID-19）引发的神经系统并发症较为常见，且新的表现形式正不断被认识到。轻度脑炎伴可逆性胼胝体压部病变（MERS）是一种与病毒感染相关的综合征，但之前与 COVID-19 无关。在本报告中，我们描述了一例 69 岁男性的病例，其在弥散受限的胼胝体压部病变的背景下出现发热和脑病，最初类似于缺血性脑卒中。全面的感染性检查显示严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）抗体呈阳性，且实验室检查显示存在 COVID-19 感染的促炎特征。他的症状得到缓解，重复影像学检查显示脑部 MRI 表现完全正常，符合 MERS 的表现。该病例提示 MERS 可能表现为 SARS-CoV-2 感染的自身免疫反应，对于近期 COVID-19 感染且具有典型 MERS 临床-放射学综合征的患者应考虑该诊断。
