COVID‐19‐related encephalopathy: a case series with brain FDG‐positron‐emission tomography/computed tomography findings
Open accessAbstract
Aim: The aim of this paper is to describe the clinical features of COVID‐19‐related encephalopathy and their metabolic correlates using brain 2‐desoxy‐2‐fluoro‐D‐glucose (FDG)‐positron‐emission tomography (PET)/computed tomography (CT) imaging. Background and purpose: A variety of neurological manifestations have been reported in association with COVID‐19. COVID‐19‐related encephalopathy has seldom been reported and studied. Methods: We report four cases of COVID‐19‐related encephalopathy. The diagnosis was made in patients with confirmed COVID‐19 who presented with new‐onset cognitive disturbances, central focal neurological signs, or seizures. All patients underwent cognitive screening, brain magnetic resonance imaging (MRI), lumbar puncture, and brain 2‐desoxy‐2‐fluoro‐D‐glucose (FDG)‐positron‐emission tomography (PET)/computed tomography (CT) (FDG‐PET/CT). Results: The four patients were aged 60 years or older, and presented with various degrees of cognitive impairment, with predominant frontal lobe impairment. Two patients presented with cerebellar syndrome, one patient had myoclonus, one had psychiatric manifestations, and one had status epilepticus. The delay between first COVID‐19 symptoms and onset of neurological symptoms was between 0 and 12 days. None of the patients had MRI features of encephalitis nor significant cerebrospinal fluid (CSF) abnormalities. SARS‐CoV‐2 RT‐PCR in the CSF was negative for all patients. All patients presented with a consistent brain FDG‐PET/CT pattern of abnormalities, namely frontal hypometabolism and cerebellar hypermetabolism. All patients improved after immunotherapy. Conclusions: Despite varied clinical presentations, all patients presented with a consistent FDG‐PET pattern, which may reflect an immune mechanism.
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A small case series of COVID-19 patients with acute encephalopathy suggested that the disease may be associated with a specific frontal hypo-metabolism pattern on FDG-PET.
“A small case series of COVID-19 patients with acute encephalopathy suggested that the disease may be associated with a specific frontal hypo-metabolism pattern on FDG-PET [148]”
From Cognitive decline following acute viral infections: literature review and projections for post-COVID-19 (2022) · cites this paper as [148]
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- Authors
- Delorme, C., Paccoud, O., Kas, A., Hesters, A., Bombois, S., Shambrook, P., Boullet, A., Doukhi, D., Le Guennec, L., Godefroy, N., Maatoug, R., Fossati, P., Millet, B., Navarro, V., Bruneteau, G., Demeret, S., Pourcher, V., & the CoCo‐Neurosciences study group and COVID SMIT PSL study group
- Affiliations
- Sorbonne Université (FR)
- Inserm (FR)
- Department of Neurology Sorbonne University Assistance Publique des Hôpitaux de Paris (AP‐HP) University Hospitals ‐ Pitié‐Salpêtrière Charles Foix Paris France
- Corresponding author
- Pourcher, V.
- ORCID
- Venue
- European Journal of Neurology
- Publisher
- Wiley
- Published
- 2020-09-22
- Volume
- 27
- Issue
- 12
- Pages
- 2651-2657
- ISSN
- 1351-5101 (ISSN-L)
- 1468-1331
- PMC
- PMC7461074
- OpenAlex
- W3049257232
- Cited by
- 173
- References
- 17
- Citations by year
- 2026: 4 · 2025: 8 · 2024: 21 · 2023: 26 · 2022: 38 · 2021: 65 · 2020: 10
- FWCI
- 15.05
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- European Journal of Neurology (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Assistance publique-Hôpitaux de Paris
- Topics
- Health Sciences › Medicine › Neurology › Long-Term Effects of COVID-19
- Health Sciences › Medicine › Infectious Diseases › Infectious Encephalopathies and Encephalitis
- Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
- Keywords
- SARS-CoV-2, FDG PET/CT, brain hypometabolism, frontal lobe hypometabolism, cerebellar hypermetabolism, cognitive impairment, cerebellar syndrome, myoclonus, status epilepticus, immunotherapy, neurological manifestations of COVID-19
- MeSH terms
- Positron Emission Tomography Computed Tomography, COVID-19, Aged, Mental Disorders, Brain Diseases, Cerebellar Diseases, Cognition Disorders, Female, Frontal Lobe, Humans, Immunotherapy, Magnetic Resonance Imaging, Male, Middle Aged, Myoclonus, Neuropsychological Tests, Status Epilepticus, Treatment Outcome, Radiopharmaceuticals, Fluorodeoxyglucose F18
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