Volume 13, Issue 2 pp. 124-126
CLINICAL LETTER

Coronavirus disease 2019-associated encephalopathy: Characteristic brainstem and bilateral temporal lobe involvement

Yasutaka Tajima

Corresponding Author

Yasutaka Tajima

Department of Neurology, Brain Science Center, Sapporo City General Hospital, Sapporo, Japan

Correspondence

Yasutaka Tajima MD, Department of Neurology, Brain Science Centre, Sapporo City General Hospital, N11 W13 Chu-o-ku, Sapporo 060-8604, Japan.

Email: [email protected]

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Chika Sato

Chika Sato

Department of Neurology, Brain Science Center, Sapporo City General Hospital, Sapporo, Japan

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Yasunori Mito

Yasunori Mito

Department of Neurology, Brain Science Center, Sapporo City General Hospital, Sapporo, Japan

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First published: 20 January 2022

Abstract

Background

As COVID-19 has become a worldwide pandemic, various neurological manifestations associated with the virus have been discovered. Apart from cerebrovascular disorders, central nervous system inflammation associated with COVID-19 has also been reported.

Case Presentation

Here we report a rare case of COVID-19 encephalopathy in Japan that specifically involved the brainstem and bilateral temporal lobes. In addition to the moderate respiratory damage, the patient developed generalized seizures followed by severe disturbance of consciousness. MRI examinations demonstrated characteristic involvement of the brainstem and bilateral temporal lobes. Pulsed steroid treatment effectively resolved the abnormal MRI findings.

Conclusions

The mechanisms of neuronal damage in COVID-19 remain undetermined, but pathogenesis of this case should be considered an autoimmune mechanism rather than direct viral damage to the central nervous system in COVID-19.

CONFLICTS OF INTEREST

The authors declare no conflict of interest.

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