Quadriplegia, Dysphagia and Ataxia Manifested in a Child With COVID-19 Related Acute Necrotizing Encephalopathy: A Case Report
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2, presents primarily with respiratory symptoms. However, children with COVID-19 are usually asymptomatic or mild acute symptoms and also neurological manifestations have also been observed. We report the case of a 7-year-old girl who presented with high fever and altered mental status, leading to a diagnosis of COVID-19 and acute necrotizing encephalopathy (ANE). The patient received intensive medical care in the intensive care unit and subsequently underwent rehabilitation programs due to neurological functional sequelae. Neurological complications in COVID-19, including ANE, may result from potential viral nerve involvement, cytokine storms, and the blood-brain barrier disruption. Early rehabilitation plays a pivotal role in managing COVID-19-related neurological complications and enhancing patients' functional outcomes. Further research is essential to gain a better understanding of the mechanisms and treatment strategies for neurological manifestations in pediatric COVID-19 patients, particularly those with multisystem inflammatory syndrome in child.
Abstract
Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2, presents primarily with respiratory symptoms. However, children with COVID-19 are usually asymptomatic or mild acute symptoms and also neurological manifestations have also been observed. We report the case of a 7-year-old girl who presented with high fever and altered mental status, leading to a diagnosis of COVID-19 and acute necrotizing encephalopathy (ANE). The patient received intensive medical care in the intensive care unit and subsequently underwent rehabilitation programs due to neurological functional sequelae. Neurological complications in COVID-19, including ANE, may result from potential viral nerve involvement, cytokine storms, and the blood-brain barrier disruption. Early rehabilitation plays a pivotal role in managing COVID-19-related neurological complications and enhancing patients' functional outcomes. Further research is essential to gain a better understanding of the mechanisms and treatment strategies for neurological manifestations in pediatric COVID-19 patients, particularly those with multisystem inflammatory syndrome in child.
참고문헌 (20)
- Guan WJ, "Clinical characteristics of coronavirus disease 2019 in China", N Engl J Med, 382, pp.1708~1720 (2020)
- Harapan BN, "Neurological symptoms, manifestations, and complications associated with severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)and coronavirus disease 19(COVID-19)", J Neurol, 268, pp.3059~3071 (2021)
- Akçay N, "Bilateral lentiform and caudate nucleus lesions in a child with COVID-19 : a case report", Biomed J, 45, pp.957~960 (2022)
- Carod-Artal FJ, "Neurological complications of coronavirus and COVID-19", Rev Neurol, 70, pp.311~322 (2020)
- Lin JE, "Neurological issues in children with COVID-19", Neurosci Lett, 743, pp.135567~ (2021)
- Aghagoli G, "Neurological involvement in COVID-19 and potential mechanisms : a review", Neurocrit Care, 34, pp.1062~1071 (2021)
- Diwanmal S, "Rehabilitation outcomes in acute necrotizing encephalopathy of childhood – a retrospective study", Indian J Physiother Occup Ther, 15, pp.125~130 (2021)
- Baig AM, "Updates on what ACS reported : emerging evidences of COVID-19 with nervous system involvement", ACS Chem Neurosci, 11, pp.1204~1205 (2020)
- Poyiadji N, "COVID-19-associated acute hemorrhagic necrotizing encephalopathy : imaging features", Radiology, 296, pp.E119~E120 (2020)
- Virhammar J, "Acute necrotizing encephalopathy with SARS-CoV-2 RNA confirmed in cerebrospinal fluid", Neurology, 95, pp.445~449 (2020)
- Albu S, "Multidisciplinary outpatient rehabilitation of physical and neurological sequelae and persistent symptoms of COVID-19 : a prospective, observational cohort study", Disabil Rehabil, 44, pp.6833~6840 (2022)
- Raciti L, "Neurological complications of COVID-19 : from pathophysiology to rehabilitation. An overview", Acta Biomed, 92, pp.e2021317~ (2021)
- Lin X, "Acute necrotizing encephalopathy in children with COVID-19 : a retrospective study of 12 cases", Front Neurol, 14, pp.1184864~ (2023)
- Lazarte-Rantes C, "Acute necrotizing encephalopathy associated with SARS-COV-2 exposure in a pediatric patient", Cureus, 13, pp.e15018~ (2021)
- Stefanou MI, "Neurological manifestations of long-COVID syndrome : a narrative review", Ther Adv Chronic Dis, 13, pp.20406223221076890~ (2022)
- Whiteson JH, "Multi-disciplinary collaborative consensus guidance statement on the assessment and treatment of cardiovascular complications in patients with post-acute sequelae of SARS-CoV-2 infection(PASC)", PM R, 14, pp.855~878 (2022)
- Sarkar S, "Neurological damages in COVID-19 patients : mechanisms and preventive interventions", MedComm(2020), 4, pp.e247~ (2023)
- Jean A, "Brain stem control of swallowing : neuronal network and cellular mechanisms", Physiol Rev, 81, pp.929~969 (2001)
- Martin RE, "Cerebral areas processing swallowing and tongue movement are overlapping but distinct : a functional magnetic resonance imaging study", J Neurophysiol, 92, pp.2428~2443 (2004)
- Marek M, "Ataxia and tremor due to lesions involving cerebellar projection pathways : a DTI tractographic study in six patients", J Neurol, 262, pp.54~58 (2015)