In this paper recently published in Annals of Neurology, Pilotto et al., described the case of a 60-year old subject with SARS-CoV-2 infection but only mild respiratory abnormalities who developed akinetic mutism due to encephalitis. Cranial MRI was negative whereas EEG showed generalised theta slowing. Cerebrospinal fluid (CSF) analysis during the acute stage was negative for SARS-CoV-2, but pleocytosis and hyperproteinorrachia was seen, with increased IL-8 and TNF-α concentrations; other infectious or autoimmune disorders were excluded. Progressive clinical and CSF improvement was observed after high-dose steroid treatment, and the authors argued that this supported inflammatory-mediated brain involvement related to Covid-19.
by Marialuisa Zedde and Francesco Cavallieri