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KMID : 1201420220150020131
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Journal of Neurocritical Care
2022 Volume.15 No. 2 p.131 ~ p.135
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Successful treatment of post?COVID-19 acute disseminated encephalomyelitis with urgent immunotherapy and neurointensive management: a case report
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Lee Jung-Seok
Kim Hong-Jun
Kim Joong-Goo
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Abstract
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Background: Acute disseminated encephalomyelitis (ADEM)-like white matter disease, a rare complication of coronavirus disease 2019 (COVID-19), is a potentially life-threatening neurological disorder. The objective of this study was to report the successful treatment of post?COVID-19 ADEM with urgent immunotherapy and neurointensive management.
Case Report: A 53-year-old female patient was referred to our hospital with a 2-day history of progressive mental deterioration and was diagnosed with ADEM after COVID-19. The patient's symptoms worsened despite the administration of high-dose steroids, and targeted temperature management was employed to manage brain edema. Additionally, the neurointensivist decided to use intravenous immunoglobulin early for intractable post?COVID-19 ADEM. Her mental status and neuroimaging findings showed rapid improvement at about 3 months after admission.
Conclusion: This case highlights that if the patient's symptoms worsen despite high-dose steroid administration in the acute stage, early use of intravenous immunoglobulin is expected to have a positive effect on the prognosis of patients with post?COVID-19 ADEM.
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KEYWORD
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COVID-19, Encephalomyelitis, Acute disseminated encephalomyelitis, Immunotherapy, Neuroimaging
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