RESUMO
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.
Assuntos
Encefalopatias/diagnóstico por imagem , COVID-19/complicações , Idoso , Encefalopatias/psicologia , Encefalopatias/terapia , COVID-19/terapia , Doenças Cerebelares/diagnóstico por imagem , Doenças Cerebelares/etiologia , Transtornos Cognitivos/etiologia , Transtornos Cognitivos/psicologia , Feminino , Fluordesoxiglucose F18 , Lobo Frontal/diagnóstico por imagem , Humanos , Imunoterapia , Imageamento por Ressonância Magnética , Masculino , Transtornos Mentais/etiologia , Transtornos Mentais/psicologia , Pessoa de Meia-Idade , Mioclonia/diagnóstico por imagem , Mioclonia/etiologia , Testes Neuropsicológicos , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Compostos Radiofarmacêuticos , Estado Epiléptico/etiologia , Resultado do TratamentoRESUMO
Christophers' stages durations and effect of interrupted blood meal were investigated in laboratory to study the gonotrophic cycle of Aedes caspius (Pallas, 1771). A first experiment was done with replete females (full blood meal) and females with an interrupted blood meal. Females were then regularly dissected, the durations of Christophers' stages I, II, III, IV, V were up to 8, 8, 32, 8, 48 h, respectively. A second experiment was done with replete females, females with an interrupted blood meal and females with an interrupted blood meal completed 24 h later. Interrupted females matured 21 +/- 5 follicles, interrupted-completed females 92 +/- 11, and replete females 120 +/- 8 follicles.
