Abstract
Background
Since the emergence of SARS COVID-2 which resulted in a global pandemic infecting million, post-COVID encephalitis is an increasingly recognized entity.
The current literature reports cases with brainstem, limbic and cerebellar involvement with good correlation with radiological findings.
We report a case of post-COVID seronegative autoimmune encephalitis with predominant cerebellar dysfunction in a 19-year-old university student with radiological findings involving the temporal lobe and thalamus.
Investigations and treatment progress
Serum and CSF investigations confirmed to diagnosis of COVID upper respiratory tract infection (URTI). However extensive serum and CSF screen for autoimmune encephalitis was negative for any antibodies.
MRI scan showed FLAIR hyperintensities within the temporal lobe, thalamus, pons and cerebellar region.
He was treated with pulse methylprednisolone and prolonged steroid wean with excellent response.
Goals and learning points of this presentation
Neuroimaging is an important tool in the diagnosis of autoimmune encephalitis as there may be more extensive involvement beyond the initial clinical presentation.
Antibodies may be negative in COVID related encephalitis. Hence the diagnosis can be made based on clinical presentation and neuroimaging.
Steroids can be an effective immunosuppression therapy which should be considered when managing patient’s with COVID related encephalitis.
