COVID-19 encephalitis with SARS-CoV-2 detected in cerebrospinal fluid presenting as a stroke mimic
COVID-19 encephalitis with SARS-CoV-2 detected in cerebrospinal fluid presenting as a stroke mimic
We report the case of a 35-year-old male with COVID-19 encephalitis presenting as a stroke mimic with sudden-onset expressive and receptive dysphasia, mild confusion and right arm incoordination. The patient received thrombolysis for a suspected ischaemic stroke, but later became febrile and SARS-CoV-2 was detected in cerebrospinal fluid. Electroencephalography demonstrated excess in slow waves, but neuroimaging was reported as normal. Respiratory symptoms were absent throughout and nasopharyngeal swab was negative for SARS-CoV-2. At the most recent follow-up, the patient had made a full neurological recovery. Clinicians should therefore consider testing for SARS-CoV-2 in CSF in patients who present with acute focal neurology, confusion and fever during the pandemic, even when there is no evidence of respiratory infection.
COVID-19, Encephalitis, SARS-Cov-2, Stroke mimic
105915
Glavin, Diarmuid
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Kelly, Denise
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Wood, Greta K
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Mccausland, Beth MS
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Ellul, Mark A
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Varatharaj, Aravinthan
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Galea, Ian
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Thomas, Rhys H
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Michael, Benedict D
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Gallen, Brian
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September 2021
Glavin, Diarmuid
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Kelly, Denise
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Wood, Greta K
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Mccausland, Beth MS
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Ellul, Mark A
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Varatharaj, Aravinthan
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Galea, Ian
66209a2f-f7e6-4d63-afe4-e9299f156f0b
Thomas, Rhys H
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Michael, Benedict D
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Gallen, Brian
c42a4139-0895-4e81-9975-fea95b226cac
Glavin, Diarmuid, Kelly, Denise, Wood, Greta K, Mccausland, Beth MS, Ellul, Mark A, Varatharaj, Aravinthan, Galea, Ian, Thomas, Rhys H, Michael, Benedict D and Gallen, Brian
(2021)
COVID-19 encephalitis with SARS-CoV-2 detected in cerebrospinal fluid presenting as a stroke mimic.
Journal of Stroke and Cerebrovascular Diseases, 30 (9), , [105915].
(doi:10.1016/j.jstrokecerebrovasdis.2021.105915).
Abstract
We report the case of a 35-year-old male with COVID-19 encephalitis presenting as a stroke mimic with sudden-onset expressive and receptive dysphasia, mild confusion and right arm incoordination. The patient received thrombolysis for a suspected ischaemic stroke, but later became febrile and SARS-CoV-2 was detected in cerebrospinal fluid. Electroencephalography demonstrated excess in slow waves, but neuroimaging was reported as normal. Respiratory symptoms were absent throughout and nasopharyngeal swab was negative for SARS-CoV-2. At the most recent follow-up, the patient had made a full neurological recovery. Clinicians should therefore consider testing for SARS-CoV-2 in CSF in patients who present with acute focal neurology, confusion and fever during the pandemic, even when there is no evidence of respiratory infection.
Text
Glaven et al 2021_accepted
- Accepted Manuscript
More information
Accepted/In Press date: 23 May 2021
e-pub ahead of print date: 31 May 2021
Published date: September 2021
Additional Information:
Funding
IG and AV are supported by NIHR and MRC. BDM is supported to conduct COVID-19 neuroscience research by the UKRI/MRC (MR/V03605X/1); for additional neurological inflammation research due to viral infection BDM is also supported by grants from the MRC/UKRI (MR/V007181//1), MRC (MR/T028750/1) and Wellcome (ISSF201902/3). The funding sources had no role in the writing of this report or decision to submit the article for publication.
Keywords:
COVID-19, Encephalitis, SARS-Cov-2, Stroke mimic
Identifiers
Local EPrints ID: 450678
URI: http://eprints.soton.ac.uk/id/eprint/450678
ISSN: 1052-3057
PURE UUID: 9441fa0d-df19-4fcd-95f2-374957b4bf38
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Date deposited: 06 Aug 2021 16:30
Last modified: 17 Mar 2024 06:44
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Contributors
Author:
Diarmuid Glavin
Author:
Denise Kelly
Author:
Greta K Wood
Author:
Beth MS Mccausland
Author:
Mark A Ellul
Author:
Rhys H Thomas
Author:
Benedict D Michael
Author:
Brian Gallen
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