Abstract
Objective This case report describes a patient with mesencephalic MRI signal abnormality and diplopia, possibly associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.
Methods We describe a boy with binocular diplopia and nystagmus. The pattern of serology positivity and negative direct research of SARS-CoV-2 RNA in our patient allowed us to consider novel coronavirus as the trigger of possible immune-mediated phenomena against the central nervous system.
Results During hospitalization, blood tests revealed a recent SARS-CoV-2 infection. MRI revealed hyperintensity of the mesencephalic tegmentum and periaqueductal region, consistent with an inflammatory lesion of the midbrain tegmentum. Viral and bacterial molecular screening on cerebrospinal fluid and isoelectrofocusing analysis, anti–myelin oligodendrocyte glycoprotein, anti–aquaporine-4, and anti–N-methyl-d-aspartate antibodies were negative. The patient was treated with steroids and immunoglobulin therapy with complete remission of neurologic symptoms.
Discussion This report expands the spectrum of pediatric COVID-19–associated neurologic symptoms and highlights a possible isolated neurologic COVID-19–related symptom.
Footnotes
Funding information and disclosures are provided at the end of the article. Full disclosure form information provided by the authors is available with the full text of this article at Neurology.org/cp.
↵* These authors contributed equally to this work as first authors.
Submitted and externally peer reviewed. The handling editor was Editor Luca Bartolini, MD.
COVID-19 Resources: NPub.org/COVID19
- Received April 14, 2022.
- Accepted July 28, 2022.
- © 2022 American Academy of Neurology
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