Section of Internal Medicine, Department of Medicine, The Aga Khan University Hospital, Karachi, Pakistan.
Section of Internal Medicine, Department of Medicine, The Aga Khan University Hospital, Karachi, Pakistan
BMJ Case Rep. 2022 Mar 8;15(3):e245387. doi: 10.1136/bcr-2021-245387.
Although neurological manifestations such as headache and myalgias have been observed with COVID-19, presentation with more serious neurological illness is uncommon and rare. We report a case of a middle-aged woman who presented to the emergency department of a tertiary care hospital. Her clinical presentation was primarily neurological rather than the more common presentation with respiratory manifestations. She presented with generalised tonic-clonic seizures, along with history of undocumented low-grade fever and generalised body aches. The positive SARS-CoV-2 RT-PCR nasal swab, the cerebrospinal fluid analysis (lymphocytic pleocytosis) and electroencephalogram were consistent with viral encephalitis; brain imaging was unremarkable. This case highlights the variable presenting features of COVID-19 infection as patients can primarily present with neurological manifestations in the absence of significant respiratory symptoms. We believe it is important to recognise neurological disease associated with SARS-CoV-2 in patients with asymptomatic respiratory infection.
尽管 COVID-19 会出现头痛和肌肉疼痛等神经系统表现，但出现更严重神经系统疾病的情况并不常见。我们报告了一例中年女性病例，她因主要表现为神经系统而非更常见的呼吸系统表现而到三级医院急诊科就诊。她表现为全身性强直阵挛发作，伴有未经记录的低热和全身性肌肉疼痛病史。SARS-CoV-2 RT-PCR 鼻拭子、脑脊液分析（淋巴细胞增多）和脑电图结果与病毒性脑炎一致；脑部影像学检查无明显异常。本病例强调了 COVID-19 感染的多变表现特征，因为患者在没有明显呼吸道症状的情况下主要表现为神经系统症状。我们认为，重要的是要认识到无症状呼吸道感染患者与 SARS-CoV-2 相关的神经系统疾病。
