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Covid-19-Associated Acute Necrotizing Encephalopathy: A Case Report Publisher



Fazelnia F1 ; Hasani S2 ; Zamani F3 ; Shabanian R4
Authors
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Authors Affiliations
  1. 1. Department of Radiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Department of Radiology, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
  3. 3. Department of Radiology, Children Medical Center of excellence, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Department of Pediatric Cardiology, Children’s Medical Center, Tehran University of Medical Sciences, Iran

Source: Iranian Journal of Child Neurology Published:2023


Abstract

COVID-19 is a pandemic disease in which most patients have pulmonary symptoms. However, several cases of CNS involvement associated with COVID-19 have been reported. Acute necrotizing encephalopathy of childhood (ANEC) is a rare CNS complication of viral infections such as influenza, herpes virus, and COVID-19, leading to high mortality and morbidity rates. Several cases of COVID-19-associated acute necrotizing encephalopathy (ANE) have been reported since March 2020 in adults, with just a few cases in pediatrics. This article reports a 5-month-old child who presented with seizures, with the final diagnosis of ANE as a complication of COVID-19. MRI findings of ANEC, as reported in most COVID-19-associated ANEC case reports, involve bilateral, symmetric, multifocal lesions in the central thalami. Moreover, the brainstem, cerebral white matter, and cerebellum could be affected. The prognosis of COVID-19-associated ANE is poor, leading to neurologic dysfunction or mortality. COVID-19-associated ANE cases must be reported, especially in pediatrics, with detailed clinical history, laboratory data, and radiologic findings to introduce diagnostic criteria, prognosis, and a management protocol. © 2023 The Authors. Published by Shahid Beheshti University of Medical Sciences.