A First Case of Acute Cerebellitis Associated with Coronavirus Disease (COVID-19): a Case Report and Literature Review
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A First Case of Acute Cerebellitis Associated with Coronavirus Disease (COVID-19): a Case Report and Literature Review Nima Fadakar 1 & Sara Ghaemmaghami 1 & Seyed Masoom Masoompour 2 & Babak Shirazi Yeganeh 3 & Ali Akbari 4 & Sedighe Hooshmandi 5 & Vahid Reza Ostovan 1
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Novel coronavirus (severe acute respiratory syndrome-coronavirus-2: SARS-CoV-2), which originated from Wuhan, China, has spread to the other countries in a short period of time. We report a 47-year-old male who was admitted to our hospital due to suffering from progressive vertigo and ataxia for 7 days prior to the admission. Neurological examination revealed cerebellar dysfunction, and brain magnetic resonance imaging (MRI) depicted edema of the cerebellar hemisphere associated with leptomeningeal enhancement. Cerebrospinal fluid (CSF) analysis showed mild lymphocytic pleocytosis, elevated protein, and lactate dehydrogenase. SARS-CoV-2 RNA was detected in the oropharyngeal/nasopharyngeal and CSF specimens. As a result, treatment with lopinavir/ritonavir was initiated, and patient symptoms and signs improved significantly during the course of hospitalization. To the best of our knowledge, this is the first case of acute cerebellitis associated with COVID-19 disease which is reported in the literature so far. Keywords COVID-19 . SARS-COV-2 . Ataxia . Vertigo . Cerebellitis . Magnetic resonance imaging
Introduction In December 2019, novel coronavirus (severe acute respiratory syndrome-coronavirus-2: SARS-CoV-2) arose from the city of Wuhan, Hubei Province, China. The disease has rapidly expanded into the other countries and developed into a pandemic [1]. Angiotensin-converting enzyme 2(ACE-2) and dipeptidyl peptidase 4 (DPP4) receptors are rarely expressed in the central nervous system except in certain circumstances, such as temporal lobe epilepsy and neurodegenerative
* Vahid Reza Ostovan [email protected] 1
Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz 7193635899, Iran
2
Non-Communicable Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
3
Pathology Department, Shiraz University of Medical Sciences, Shiraz, Iran
4
Anesthesiology Department, Shiraz University of Medical Sciences, Shiraz, Iran
5
Medical Imaging Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
disorders [2, 3]. Several preliminary reports demonstrated neurological manifestations in the patients infected with SARS-CoV-2 [4, 5]. Central nervous system involvement usually occurs in severe cases of SARS-CoV-2 infection; however, according to the recent reports, neurological manifestations may be the presenting features of COVID-19 [6, 7]. Herein, we report the first case of acute cerebellitis in association with COVID-19 that is confirmed by the detection of SARS-CoV-2 RNA in the cerebrospinal fluid (CSF).
Case Report A 47-year-old man presented to our emergency department complaining of body pain, p
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