Top

Published in:

01-10-2021 | Cranial MRI | Brief Communication

ADEM post-Sars-CoV-2 infection in a pediatric patient with Fisher-Evans syndrome

Authors: Maria Laura Manzo, Cristina Galati, Cristina Gallo, Giuseppe Santangelo, Antonio Marino, Fulvio Guccione, Renata Pitino, Vincenzo Raieli

Published in: Neurological Sciences | Issue 10/2021

Abstract

Introduction

Sars-CoV-2 is a single-strained RNA virus belonging to Coronaviridae’s family. In pediatric age, the majority of patients is asymptomatic; however, several neurological manifestations associated with Sars-CoV-2 infection have been detected in a percentage of cases ranging from 17.3 to 36.4%. Acute disseminated encephalomyelitis (ADEM) has been recently included among the potential complications of Sars-Cov2 infection. The available data regarding pediatric patient show only one case.

Case report

We present a case regarding a 6-year-old patient suffering from Fisher-Evans syndrome who was given sirolimus and thalidomide therapy. After 10 days since the first positive nasopharyngeal swab for Sars-CoV-2, in which he had no symptoms, he presented an episode of generalized tonic-clonic seizure with spontaneous resolution. The patient underwent MRI which showed the typical picture of acute disseminated encephalomyelitis. His clinical course was favorable, with a good response to cortisone therapy and a progressive improvement of the neuroradiological and electroencephalographic picture.

Conclusions

According to our knowledge, this is the second case of an acute disseminated encephalomyelitis following SARS-CoV-2 infection in a pediatric patient, characterized by monosymptomatic onset, in which the immunosuppressive therapy practiced for the Fisher-Evans syndrome has probably contributed to a favorable evolution of ADEM, in contrast to other case described in the literature.

Christy A (2020) COVID-19: a review for the pediatric neurologist. J Child Neurol 35(13) SAGE Publications Inc.:934–939. https://doi.org/10.1177/0883073820939387CrossRefPubMed

Correia AO, Feitosa PWG, Moreira JL d S, Nogueira SÁR, Fonseca RB, Nobre MEP (2020) Neurological manifestations of COVID-19 and other coronaviruses: a systematic review. Neurol Psychiatry Brain Res 37. Elsevier GmbH:27–32. https://doi.org/10.1016/j.npbr.2020.05.008CrossRefPubMedPubMedCentral

Novi G, Rossi T, Pedemonte E, Saitta L, Rolla C, Roccatagliata L, Inglese M, Farinini D (2020) Acute disseminated encephalomyelitis after SARS-CoV-2 infection. Neurol Neuroimmunol Neuroinflammation 7(5):2–5. https://doi.org/10.1212/NXI.0000000000000797CrossRef

De Miranda Henriques-Souza A., De Melo A., De Aguiar Coelho Silva Madeiro B, Freitas L, Rocha-Filho P, Goncalves F Acute disseminated encephalomyelitis in a COVID-19 pediatric patient. https://doi.org/10.1007/s00234-020-02571-0/Published

McCuddy M, Kelkar P, Zhao Y, Wicklund D (2020) Acute demyelinating encephalomyelitis (ADEM) in COVID-19 infection: a case series. medRxiv 5:5–8. https://doi.org/10.1101/2020.07.15.20126730CrossRef

S. Audia, N. Grienay, M. Mounier, M. Michel, and B. Bonnotte, “Evans’ syndrome: from diagnosis to treatment,” J Clin Med., 9, 12, 3851, 2020, doi: 10.3390/jcm9123851

Leake J, Albani S, Kao A et al (2004) Acute disseminated encephalomyelitis in childhood: epidemiologic, clinical and laboratory features. Pediatr Infect Dis J 23(8):756–764. https://doi.org/10.1097/01.inf.0000133048.75452.ddCrossRefPubMed

Cole J, Evans E, Mwangi M, Mar S (2019) Acute disseminated encephalomyelitis in children: an updated review based on current diagnostic criteria. Pediatr Neurol 100:26–34. https://doi.org/10.1016/j.pediatrneurol.2019.06.017CrossRefPubMed

Gheith O, Cerna M, Halim MA et al (2017) Sirolimus-induced combined posterior reversible encephalopathy syndrome and lymphocytic pneumonitis in a renal transplant recipient: case report and review of the literature. Exp Clin Transplant 15:170–174. https://doi.org/10.6002/ect.mesot2016.P36CrossRefPubMed

10.

Atrah HI (2020) Alternative management of Covid-19 infection. Scott Med J 65(3):72–75. https://doi.org/10.1177/0036933020941497CrossRefPubMedPubMedCentral

Title: ADEM post-Sars-CoV-2 infection in a pediatric patient with Fisher-Evans syndrome
Authors: Maria Laura Manzo
Cristina Galati
Cristina Gallo
Giuseppe Santangelo
Antonio Marino
Fulvio Guccione
Renata Pitino
Vincenzo Raieli
Publication date: 01-10-2021
Publisher: Springer International Publishing
Keywords: Cranial MRI
SARS-CoV-2
Epilepsy
Epileptic Seizure
Headache
Posterior Reversible Encephalopathy Syndrome
Published in: Neurological Sciences / Issue 10/2021
Print ISSN: 1590-1874
Electronic ISSN: 1590-3478
DOI: https://doi.org/10.1007/s10072-021-05311-1

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

ADEM post-Sars-CoV-2 infection in a pediatric patient with Fisher-Evans syndrome

Abstract

Introduction

Case report

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Case report

Conclusions

Please log in to get access to this content

Other articles of this Issue 10/2021

Classic and overlapping Miller-Fisher syndrome: clinical and electrophysiological features in Mexican adults

Headache Gauge: a real-life calendar-based tool for headache monitoring

Zonisamide in Parkinson’s disease: a current update

Acetylcholinesterase inhibitor responsive myasthenia in a Filipino male with X-linked recessive spinal and bulbar muscular atrophy

Predictors of survival in older adults hospitalized with COVID-19

Can diplopia complaint be reduced by telerehabilitation in multiple sclerosis patient during the pandemic?: A case report