COVID-19 Encephalitis with SARS-CoV-2 Detected in Cerebrospinal Fluid Presenting as a Stroke Mimic



Glavin, Diarmuid, Kelly, Denise, Wood, Greta Karen ORCID: 0000-0001-6098-2331, McCausland, Beth MS, Ellul, Mark Alexander ORCID: 0000-0002-6115-8245, Varatharaj, Aravinthan, Galea, Ian, Thomas, Rhys Huw, Michael, Benedict Daniel ORCID: 0000-0002-8693-8926 and Gallen, Brian
(2021) COVID-19 Encephalitis with SARS-CoV-2 Detected in Cerebrospinal Fluid Presenting as a Stroke Mimic. JOURNAL OF STROKE & CEREBROVASCULAR DISEASES, 30 (9). 105915-.

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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.

Item Type: Article
Uncontrolled Keywords: Encephalitis, COVID-19, SARS-Cov-2, Stroke mimic
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Infection, Veterinary and Ecological Sciences
Depositing User: Symplectic Admin
Date Deposited: 23 Aug 2021 09:02
Last Modified: 18 Jan 2023 21:33
DOI: 10.1016/j.jstrokecerebrovasdis.2021.105915
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3134441