• Bhavika Kakadia, Jaffer Ahmed, Todd Siegal, Tudor G Jovin, and Jesse M Thon.
• Cooper Neurological Institute, Cooper University Hospital, and Cooper Medical School of Rowan University, Camden, NJ 08103, United States.
• J Clin Neurosci. 2020 Sep 1; 79: 272-274.

AbstractNeurological complications of coronavirus 2019 (COVID-19) are common, and novel manifestations are increasingly being recognized. Mild encephalopathy with reversible splenium lesion (MERS) is a syndrome that has been associated with viral infections, but not previously with COVID-19. In this report, we describe the case of a 69 year-old man who presented with fever and encephalopathy in the setting of a diffusion-restricting splenium lesion, initially mimicking an ischemic stroke. A comprehensive infectious workup revealed positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies, and a pro-inflammatory laboratory profile characteristic of COVID-19 infection. His symptoms resolved and the brain MRI findings completely normalized on repeat imaging, consistent with MERS. This case suggests that MERS may manifest as an autoimmune response to SARS-CoV-2 infection and should be considered in a patient with evidence of recent COVID-19 infection and the characteristic MERS clinico-radiological syndrome.Copyright © 2020 Elsevier Ltd. All rights reserved.

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