Introduction Various neurologic manifestations have already been described in children during or after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections. The central nervous system disorders reported in children are mainly encephalopathies during multisystem inflammatory syndrome. We present here an acute meningoencephalitis with cerebral vasculitis associated to a coronavirus disease 2019 (COVID-19) infection in a 13-year-old girl with a 1-year clinical, electroencephalogram (EEG), and magnetic resonance imaging (MRI) follow-up. Case Report A 13-year-old girl presented acute symptoms of consciousness impairment, frontal headache, hyperthermia, and aphasia, with moderate lymphopenia (900/mm3), elevated C-reactive protein (17 mg/L), cerebrospinal fluid (CSF) pleocytosis (15 cells/mm3), slow background with frontal focalization on EEG, a left frontal ischemic lesion, leptomeningeal enhancement, and bilateral limbic fluid-attenuated inversion recovery hyperintensity on cerebral MRI. Reverse transcription-polymerase chain reaction for SARS-CoV-2 was positive in nasopharyngeal swab and COVID serology was positive for immunoglobulin (Ig) M and G, whereas extensive autoimmune antibody investigation was negative except for a positive low titer of anti-myelin oligodendrocyte glycoprotein in CSF and blood. The diagnosis of probable encephalitis associated to cerebral vasculitis after COVID infection was suggested and steroids pulse were started. She recovered within a few days. Six months later, she had moderate clinical sequels including persistent intermittent headaches, an isolated spatial deficit, and focal spikes on the EEG without argument for epilepsia. Conclusion A teenager without previous medical history presented with acute encephalitis with leptomeningitis and vasculitis after a recent COVID-19 infection. Steroids pulse therapy allowed clinical improvement. Cerebral MRI and EEG helped diagnosis, follow-up of the encephalitis, and evolution after treatment.

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13 岁儿童 COVID-19 感染后急性皮质类固醇反应性脑膜脑炎伴脑血管炎病例报告

在严重急性呼吸系统综合症冠状病毒 2 (SARS-CoV-2) 感染期间或之后，已经描述了儿童的各种神经系统表现。报道的儿童中枢神经系统疾病主要是多系统炎症综合征期间的脑病。我们在此介绍一名 13 岁女孩因 2019 年冠状病毒病 (COVID-19) 感染引起的急性脑膜脑炎伴脑血管炎，并进行了 1 年的临床、脑电图 (EEG) 和磁共振成像 (MRI) 随访——向上。病例报告 一名 13 岁女孩出现意识障碍、前额头痛、高热和失语的急性症状，伴有中度淋巴细胞减少 (900/mm3)，C 反应蛋白升高 (17 mg/L)，脑脊液 (CSF)细胞增多症（15 个细胞/mm3），慢背景脑电图额叶聚焦，左侧额叶缺血性病变，软脑膜增强，脑 MRI 上双侧边缘液衰减反转恢复高信号。鼻咽拭子中 SARS-CoV-2 的逆转录聚合酶链反应呈阳性，COVID 血清学免疫球蛋白 (Ig) M 和 G 呈阳性，而除抗髓鞘少突胶质细胞糖蛋白阳性低滴度外，广泛的自身免疫抗体研究呈阴性在 CSF 和血液中。建议诊断为可能与 COVID 感染后脑血管炎相关的脑炎，并开始使用类固醇脉冲。她在几天内康复了。六个月后，她出现了中度临床后遗症，包括持续性间歇性头痛、孤立的空间缺陷、和脑电图上的局灶性尖峰，没有癫痫的论据。结论 一名没有既往病史的青少年在最近感染 COVID-19 后出现急性脑炎伴软脑膜炎和血管炎。类固醇冲击疗法可改善临床症状。脑部 MRI 和脑电图有助于脑炎的诊断、随访以及治疗后的进展。