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Case Reports
. 2023 Dec;29(6):731-733.
doi: 10.1007/s13365-023-01183-7. Epub 2023 Nov 6.

Acute cerebellitis following COVID-19 infection associated with autoantibodies to glutamate receptors: a case report

Takuya Watanabe  1 , Yuki Kakinuma  1 , Keiko Watanabe  1 , Ryuta Kinno  2
Affiliations
Case Reports

Acute cerebellitis following COVID-19 infection associated with autoantibodies to glutamate receptors: a case report

Takuya Watanabe et al. J Neurovirol. 2023 Dec.

Abstract

While COVID-19 infection by the SARS-CoV-2 virus was initially identified as a respiratory disease, mounting evidence suggests its association with various neurological issues as well. Notably, COVID-19 has been linked to acute cerebellitis (AC) and post-infectious cerebellar ataxia. The precise underlying mechanisms behind these neurological effects remain unclear. Our case report describes AC following COVID-19 infection, associated with autoantibodies to glutamate receptors (GluRs), hinting at immunological involvement. The case is a 56-year-old woman who experienced fever and fatigue due to COVID-19 infection. About 2 weeks after these symptoms improved, she showed cerebellar symptoms such as ocular overshoot and ataxia when presenting to our hospital. Her cerebrospinal fluid (CSF) findings were normal. Brain MRI revealed cerebellar abnormalities. Treatment with methylprednisolone led to symptom improvement. Later tests of CSF yielded positive results for autoantibodies to GluRs. Our findings suggest a possible immune-mediated mechanism in the onset of AC following COVID-19 infection. Clinicians should consider the possibility of immunological pathogenesis when diagnosing cerebellar symptoms after COVID-19 infection.

Keywords: Acute cerebellitis; Autoantibody; Cerebrospinal fluid; Glutamate receptor; Post-COVID-19 infection.

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Figures

Fig. 1
Fig. 1
MRI findings of the patient. Axial DWI (left), axial T2-weighted image (middle left), and coronal FLAIR images (middle right and right) are shown. The hyperintensity in the cerebellum (arrows in DWI and FLAIR image) and edematous changes (circles in FLAIR image) was resolved after methylprednisolone treatments
See this image and copyright information in PMC

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