Half of the pediatric patients with pediatric multisystem inflammatory syndrome (MIS-C), a serious condition associated with COVID-19, developed new neurological symptoms, a UK one-center study found.
Of the 46 MIS-C patients who presented at Great Ormond Street Hospital in London between April 4 and September 1, 2020, 24 (52.2%) had new neurological involvement, Omar Abdel-Mannan, MD, of University College reported London, released in an abstract prior to the annual meeting of the American Academy of Neurology. The findings will be presented April 18 as part of the meeting’s Emerging Science program.
Headache and encephalopathy were the most common neurological symptoms. “With this new inflammatory syndrome developing after children are infected with the coronavirus, we are still learning how the syndrome affects children and what to watch out for,” Abdel-Mannan said in a statement. “We found that many children had neurological symptoms involving both the central and peripheral nervous systems.”
The median age of the patients in the study was 10; about 65% were male and 80% were not white. The researchers retroactively collected clinical and other data from electronic health records.
All 24 pediatric patients had headache, 14 had encephalopathy, six had dysarthria or dysphonia, six had hallucinations, four had ataxia, three had peripheral nerve involvement, and one had seizures.
One patient had 118 leukocytes in cerebrospinal fluid. Four of the 16 children who had a brain MRI showed changes in the splenium signal. Four of the seven patients who underwent nerve conduction examinations and EMG had myopathic and neuropathic changes; 14 of the 15 who had EEG showed excess slow activity.
Neurological symptoms were more commonly seen with more severe MIS-C presentations. Children with neurological involvement had higher peak inflammation markers and were more frequently ventilated and required inotropic support in the pediatric ICU (P <0.05).
A recent case of 1,695 US patients 21 years of age or younger hospitalized with COVID-19 or MIS-C showed that 22% had neurological involvement. Most of the symptoms in that study were transient, but 12% of patients with neurological involvement developed life-threatening problems, including encephalopathy, stroke and central nervous system infection or demyelination.
Children who develop MIS-C, also known as pediatric inflammatory multi-system syndrome, which is temporarily associated with SARS-CoV-2 (PIMS-TS) in some countries, “should definitely be assessed for neurological symptoms and longer-term cognitive outcomes,” says Abdel. -Mannan said. “More studies involving more children and monitoring children are needed to see how this condition changes over time and whether there are longer-term neurocognitive effects.”
Judy George covers neurology and neuroscience news for MedPage Today, writing about brain aging, Alzheimer’s, dementia, MS, rare diseases, epilepsy, autism, headache, stroke, Parkinson’s, ALS, concussion, CTE, sleep, pain, and more. To follow