TY - JOUR
T1 - Reply
T2 - Concentric demyelination pattern in COVID-19-associated acute haemorrhagic leukoencephalitis: A lurking catastrophe?
AU - Paterson, Ross W.
AU - Brown, Rachel L.
AU - Vivekanandam, Vinojini
AU - Foulkes, Alexander J.M.
AU - Thom, Maria
AU - Wiethoff, Sarah
AU - Benjamin, Laura
AU - Christofi, Gerry
AU - McNamara, Patricia
AU - Morrow, Jasper
AU - Miller, Thomas D.
AU - Nortley, Ross
AU - Geraldes, Ruth
AU - Attwell, David
AU - Kumar, Guru
AU - Everitt, Alex D.
AU - Davies, Nicholas W.S.
AU - Trip, S. Anand
AU - Silber, Eli
AU - Howard, Robin
AU - Perry, Richard J.
AU - Werring, David J.
AU - Checkley, Anna
AU - Longley, Nicky
AU - Spillane, Jennifer
AU - Lunn, Michael P.
AU - Hoskote, Chandrashekar
AU - Jäger, Hans Rolf
AU - Manji, Hadi
AU - Zandi, Michael S.
AU - UCL Queen Square National Hospital for Neurology and Neurosurgery COVID-19 Study Group
AU - Bharucha, Tehmina
AU - Jayaseelan, Dipa L.
AU - Raftopoulos, Rhian E.
AU - Zambreanu, Laura
AU - Khoo, Anthony
AU - Chinthapalli, Krishna
AU - Boyd, Elena
AU - Tuzlali, Hatice
AU - Price, Gary
AU - McLoughlin, Benjamin
AU - Lim, Soon Tjin
AU - Mehta, Puja R.
AU - Levee, Viva
AU - Keddie, Stephen
AU - Yong, Wisdom
AU - Hotton, Gary
AU - Carswell, Christopher
AU - Yoong, Michael
AU - Sreedharan, Jemeen
AU - Schott, Jonathan M.
AU - Chandratheva, Arvind
AU - Simister, Robert
AU - Farmer, Simon F.
AU - Carletti, Francesco
AU - Houlihan, Catherine
AU - Vincent, Angela
PY - 2020/12/1
Y1 - 2020/12/1
N2 - We are grateful to Karapanayiotides and colleagues (2020) for their description of a 57-year-old patient with acute haemorrhagic leukoencephalitis (AHLE) and concentric demyelination suggestive of Baló’s disease, and for adding insights into the neurological manifestations of COVID-19. The authors are correct to point out that the mechanisms underpinning the features in all of our collective patients remain to be determined, and the role of direct infection, hypoxia, immune-mediated injury and metabolic processes all warrant further exploration. The authors are also correct in describing the difficulty in applying historical terminology to the clinical pictures that we are now seeing in COVID-19, and that new terminologies need to be considered.In Patient 17, the clinical picture of rapid progression, unilateral significant brain swelling with oedema and ensuing coma—with evidence of brainstem dysfunction, and resolution with decompressive craniectomy and corticosteroids, fitted best clinically with previous descriptions of haemorrhagic leukoencephalitis (AHLE) (Love et al., 2008)...
AB - We are grateful to Karapanayiotides and colleagues (2020) for their description of a 57-year-old patient with acute haemorrhagic leukoencephalitis (AHLE) and concentric demyelination suggestive of Baló’s disease, and for adding insights into the neurological manifestations of COVID-19. The authors are correct to point out that the mechanisms underpinning the features in all of our collective patients remain to be determined, and the role of direct infection, hypoxia, immune-mediated injury and metabolic processes all warrant further exploration. The authors are also correct in describing the difficulty in applying historical terminology to the clinical pictures that we are now seeing in COVID-19, and that new terminologies need to be considered.In Patient 17, the clinical picture of rapid progression, unilateral significant brain swelling with oedema and ensuing coma—with evidence of brainstem dysfunction, and resolution with decompressive craniectomy and corticosteroids, fitted best clinically with previous descriptions of haemorrhagic leukoencephalitis (AHLE) (Love et al., 2008)...
KW - ADEM
KW - COVID-19
KW - encephalitis
KW - SARS-CoV-2
UR - http://www.scopus.com/inward/record.url?scp=85100070437&partnerID=8YFLogxK
U2 - 10.1093/brain/awaa377
DO - 10.1093/brain/awaa377
M3 - Letter
C2 - 33324968
AN - SCOPUS:85100070437
SN - 0006-8950
VL - 143
SP - e101
JO - Brain
JF - Brain
IS - 12
ER -
