Ataxia and Seizure as a Manifestation in a Pediatric Case of SARS-CoV-2

Abstract

Background: SARS-CoV-2 infection is an ongoing pandemic with more than seven million cases worldwide and a wide range of presenting symptoms in various ages. Neurological symptoms as mildly as a light headache and as severe as an acute encephalitis are reported. Objective: We aim to report the clinical course of pediatric patient infected with SARS-CoV-2 whom also presented ataxia and seizures as her neurological manifestation. Case: Patient was a 16 month old baby girl with clinical presentations of ataxia, focal myoclonic seizures, fever and diarrhea and no significant medical history. Her seizures were controlled with sodium valproate along with carnitine.  She developed respiratory symptoms after her RT-PCR test from her nasopharyngeal sample swap returned with positive results. We ruled out a wide range of disease such as paraneoplastic and metabolic disorders. Patient was discharged with full recovery after receiving IVIG. Discussion: We believe there is a post infectious mechanism involved that has lead the patient to have such neurological manifestations because of a significant response to IVIG while she also presented typical finds in children infected with SARS-CoV-2. Patients with SARS-CoV-2 infection can have neurological manifestations despite their negative RT-PCR test for SARS-CoV-2 in their cerebrospinal fluid. Conclusion: During the pandemic, every practitioner should have SARS-CoV-2 infection in mind when it comes to neurological manifestations without a strongly-associated explanation.