Dados do Trabalho

Título

Limbic Encephalitis Pos COVID: a Case Report

RESUMO

Case Presentation: A 57-years-old woman, hypertensive, was admitted to the neurologic emergency with a 10-day history of flu-like symptoms. After 24 hours at admission showed lowering the level of consciousness. Upon neurological exam: spatial disorientation, memory loss,irrelevant speech, Babinski sign bilateral and Brudzinski sign. SWAB COVID-19: positive. Cerebrospinal Fluid(CSF) Analysis: pleocytosis: 400 (63% lymphocytes), glucose 86mg/dL, protein: 36mg/dL, ADA 0,1, LDH 49, PCR multiplex PCR: negative.Therefore, treatment with Acyclovir and Ampicillin, but without improvement after 14 days of therapy. Furthermore, electroencephalogram (EEG) revealed non-convulsive status epilepticus despite phenytoin. Thus, new CSF analysis were performed with panel collection for limbic encephalitis research negative. Also performed magnetic ressonance (MRI) revealed limbic encephalitis pattern. Due to clinical and radiological worsening, considered post covid encephalitis. Hence, we started treatment with pulse therapy with methylprednisolone 1g for 5 days and de immunoglobulin for 5 days. She was discharged from hospital with partial improvement in behavior and interaction with the environment.

Discussion: The Limbic Encephalitis is a severe inflammatory disease that affects the limbic system. It may have infectious, inflammatory or autoimmune etiology. The diagnosis is realized with clinical, EEG, CSF analysis, Serum antibody dosage and neuroimaging. The clinical is varied,including involvement of memory, cognition,behavioral change, seizures, hallucinations, confusion and agitation. The neurological manifestations of COVID-19 including acute encephalopathies, stroke. Therefore, Immune Mediated Encephalitis post COVID 19 is the possível cause of encephalitis in this case.

Final Comm:
COVID 19 and Its complications that need to be studied. The limbic encephalitis as a neurological complication of COVID 19 should be recognized and studied as the new etiology.

Palavras Chave

Limbic Encephalitis; Post Covid Encephalitis; Lymphocitic Encephalitis; NeuroCOVID; COVID 19;