Post-COVID-19 autoimmune encephalomyelitis in an adult patient
Keywords:
autoimmune encephalomyelitis, central nervous system, COVID-19, demyelinating diseases, encephalitis, SARS-CoV-2Abstract
Introduction: COVID-19 is associated with diverse neurological complications. Autoimmune encephalomyelitis, an inflammatory and demyelinating disorder of the central nervous system, has emerged as a rare post-infectious complication that is particularly challenging to diagnose in adults.
Objective: To present the case of an adult patient with post-COVID-19 autoimmune encephalomyelitis, emphasizing the diagnostic challenges and therapeutic response.
Clinical Case: A previously healthy 54-year-old male developed neurological symptoms one month after SARS-CoV-2 infection, including gait instability, behavioral changes (aggressiveness, depression), dysarthria, lower limb weakness, and urinary urgency. The neurological examination revealed horizontal-rotatory nystagmus, ataxic gait, dysmetria, hyperreflexia, bilateral Babinski's sign, and a sensory level at T10. Imaging studies showed demyelinating lesions in the midbrain and spinal cord (T10). Cerebrospinal fluid analysis revealed elevated protein levels and a positive PCR for SARS-CoV-2. Treatment with corticosteroids and immunosuppressants led to partial improvement, although residual symptoms persisted at the 6-month follow-up.
Conclusions: This case highlights autoimmune encephalomyelitis as a rare but significant neurological complication of COVID-19 in adults, which requires a high degree of clinical suspicion for diagnosis, especially in resource-limited settings. Early immunomodulatory therapy shows potential benefits.
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Copyright (c) 2025 Mercedes Zamora Mallet, Rigoberto Betancourt Nápoles, José Ángel Rodríguez García, Yisel Peña Gutiérrez
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