A Case Report of Acute Disseminated Encephalomyelitis in a Pregnant Woman After COVID-19 Infection

Rukiye Kızılırmak; Miraç Özalp; Mehmet Armağan Osmanağaoğlu; Cavit Boz

doi:10.4274/tnd.2021.25675

Rukiye Kızılırmak¹, Miraç Özalp¹, Mehmet Armağan Osmanağaoğlu¹, Cavit Boz²

¹Karadeniz Technical University Faculty of Medicine, Department of Obstetrics and Gynecology, Clinic of Perinatology, Trabzon, Turkey
²Karadeniz Technical University Faculty of Medicine, Department of Neurology, Trabzon, Turkey

Keywords: Acute disseminated encephalomyelitis, COVID-19, neuropathology, pregnancy, SARS-CoV-2

Abstract

A 32-year-old multiparous woman at 29 weeks of gestation developed dizziness, fainting, meaningless and difficult speech, stiffness in the extremities, and movement limitation following the non-severe coronavirus disease-2019 (COVID-19) infection. Magnetic resonance imaging of the brain revealed hyperintense lesions in the white matter on T2-weighted and fluid-attenuated inversion recovery (FLAIR) sequences. The COVID-19 nasopharyngeal swab test in our center resulted negative; however, the serum COVID-19 antibody was positive. The cerebrospinal fluid was clear, no pathogen was reproduced in the culture, and the oligoclonal band was negative. Intravenous pulse steroid therapy and six cycles of plasmapheresis were administered. The symptoms improved partially; however, full recovery could not be achieved despite the treatment. This case emphasizes that acute disseminated encephalomyelitis, which can have severe consequences, should be considered in the differential diagnosis of neurological symptoms in pregnant women who are infected with COVID-19.