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

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.