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揭示新冠病毒感染后拉斯穆森脑炎:罕见神经系统并发症的病例报告

Unveiling post-COVID-19 Rasmussen's encephalitis: a case report of rare neurological complication.

作者信息

Naisr Zaira, Ahmed Abdullah Munir, Arooj Hajira, Abdullah Lava, Naeem Zunaira, Hashmi Muhammad Usman

机构信息

Rawalpindi Medical University.

King Edward Medical University.

出版信息

Ann Med Surg (Lond). 2024 Sep 12;86(10):6330-6334. doi: 10.1097/MS9.0000000000002569. eCollection 2024 Oct.

Abstract

INTRODUCTION AND IMPORTANCE

Rasmussen encephalitis (RE) is a rare autoimmune disorder that causes unilateral inflammation of the cerebral cortex and can lead to drug-resistant epilepsy and progressive neurological decline. Although the emergence of RE following COVID-19 has not been well documented, it emphasizes the need to understand the impact of COVID-19 on neurological health. This case emphasizes the importance of early recognition and intervention to prevent adverse outcomes related to post-COVID-19 neurological complications.

CASE PRESENTATION

A 30-year-old woman, recently diagnosed with COVID-19, experienced recurrent seizures that primarily affected the left side of her body. Despite medical management, signs of progressive weakness and altered consciousness were observed. Neurological examination, imaging, and electroencephalography confirmed a diagnosis of post-COVID-19 RE. Despite conservative management, the patient's condition continued to deteriorate, ultimately resulting in fatal outcomes.

CLINICAL DISCUSSION

The relationship between COVID-19 and autoimmune responses, which can lead to neurological complications, such as RE, is a matter of concern. Accurate diagnosis of RE depends on imaging and EEG studies; however, a definitive diagnosis often requires histopathological examination. The management of RE involves the use of anti-seizure medications and surgical interventions to control symptoms and improve outcomes. However, the unusual presentation of this case, along with challenges in diagnosis and treatment, underscores the need for increased awareness and extensive research on the neurological consequences of COVID-19.

CONCLUSION

This case underscores the severe neurological consequences that can emerge after COVID-19, emphasizing the need for prompt identification and intervention. Additional research is essential to improve the comprehension and management of the neurological aftermath of COVID-19 with the ultimate goal of enhancing patient outcomes.

摘要

引言与重要性

拉斯穆森脑炎(RE)是一种罕见的自身免疫性疾病,可导致大脑皮层单侧炎症,并可引发药物难治性癫痫和进行性神经功能衰退。尽管新冠病毒病(COVID-19)后出现RE的情况尚未得到充分记录,但这凸显了了解COVID-19对神经健康影响的必要性。本病例强调了早期识别和干预对于预防与COVID-19后神经并发症相关不良后果的重要性。

病例介绍

一名30岁女性,近期被诊断为COVID-19,出现主要影响其身体左侧的反复发作性癫痫。尽管进行了药物治疗,但仍观察到进行性虚弱和意识改变的迹象。神经检查、影像学检查和脑电图检查确诊为COVID-19后RE。尽管采取了保守治疗,患者病情仍持续恶化,最终导致死亡。

临床讨论

COVID-19与自身免疫反应之间的关系,后者可导致诸如RE等神经并发症,是一个令人关注的问题。RE的准确诊断依赖于影像学和脑电图研究;然而,明确诊断通常需要组织病理学检查。RE的治疗包括使用抗癫痫药物和手术干预以控制症状并改善预后。然而,本病例的不寻常表现以及诊断和治疗方面的挑战,凸显了提高对COVID-19神经后果的认识和开展广泛研究的必要性。

结论

本病例强调了COVID-19后可能出现的严重神经后果,强调了及时识别和干预的必要性。开展更多研究对于提高对COVID-19神经后遗症的理解和管理至关重要,最终目标是改善患者预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b1b3/11444579/9557c1b7b722/ms9-86-6330-g001.jpg

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