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Case Reports
. 2021 Oct 15:359:577674.
doi: 10.1016/j.jneuroim.2021.577674. Epub 2021 Jul 27.

Acute disseminated encephalomyelitis and COVID-19: A systematic synthesis of worldwide cases

Laura Zelada-Ríos  1 , Kevin Pacheco-Barrios  2 , Milagros Galecio-Castillo  3 , Cesar Yamunaqué-Chunga  3 , Kelvin Álvarez-Toledo  3 , Ricardo Otiniano-Sifuentes  4
Affiliations
Case Reports

Acute disseminated encephalomyelitis and COVID-19: A systematic synthesis of worldwide cases

Laura Zelada-Ríos et al. J Neuroimmunol. .

Abstract

Acute disseminated encephalomyelitis (ADEM) has been reported after coronavirus disease 2019 (COVID-19). In this review, we systematically included worldwide reported cases on this association. We included 30 case reports (pediatric and adults) and explored epidemiological and clinical evidence. We described time to diagnosis, clinical, imaging, and laboratory features, response to treatment regimens, and differences regarding severity. Also, an original case report was presented. Neurologists must be alert to the occurrence of multifocal neurological symptoms with or without encephalopathy in patients recovered from COVID-19. Timely MRI studies should be performed to establish the diagnosis and to consider early corticosteroid-based treatment.

Keywords: Acute disseminated encephalomyelitis (ADEM); Autoimmune disease; Central nervous system (CNS); Coronavirus disease 2019 (COVID-19); Demyelinating disease; SARS-Cov-2.

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Figures

Fig. 1
Fig. 1
(A) FLAIR-weighted axial MRI shows multiple bilateral hyperintense ovoid-like lesions in the white matter of the semioval center and radiated corona. T2-weighted and FLAIR (B and C respectively) MRI shows hyperintense lesions in the bilateral pontine tegmentum extending to the midbrain and spinal cord. (D) Gadolinium-enhanced T1-weighted image shows faint linear enhancement at the pons level (arrow).
Fig. 2
Fig. 2
(A) Sagittal T2-weighted cervical MRI shows hyperintense lesions with a patchy appearance between C2 and C7. (B) Gadolinium-enhanced T1-weighted image shows faint enhancement between C5-C7 (arrow).
Fig. 3
Fig. 3
Search flow diagram (study selection).
See this image and copyright information in PMC

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