Author: Glavin, Diarmuid; Kelly, Denise; Wood, Greta Karen; McCausland, Beth MS; Ellul, Mark Alexander; Varatharaj, Aravinthan; Galea, Ian; Thomas, Rhys Huw; Michael, Benedict Daniel; Gallen, Brian
Title: COVID-19 encephalitis with SARS-CoV-2 detected in cerebrospinal fluid presenting as a stroke mimic Cord-id: dknpdgwn Document date: 2021_5_31
ID: dknpdgwn
Snippet: 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 nasopharynge
Document: 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.
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