Radiologic-Pathologic Correlation of COVID-19-Associated Acute Disseminated Encephalomyelitis

Cureus. 2023 Jul 21;15(7):e42275. doi: 10.7759/cureus.42275. eCollection 2023 Jul.


A 42-year-old woman presented with drooling, slurred speech, inability to walk and talk, and a recent positive COVID-19 test. She had two prior hospital admissions within the past week for similar symptoms with inconclusive evaluation. MRI of the brain demonstrated multifocal white matter hyperintense lesions on fluid-attenuated inversion recovery (FLAIR)/diffusion with variable enhancement. These imaging findings have been described in recent literature and are associated with inflammatory demyelinating disease, such as acute disseminated encephalomyelitis. The patient subsequently underwent a brain biopsy with a final diagnosis of inflammatory demyelinating lesion. To our knowledge, this is the first radiologic-pathologic correlation of COVID-19-associated acute disseminated encephalomyelitis.

Keywords: acute disseminated encephalomyelitis (adem); atypical covid; covid 19; mri flair sequences; rare cause of altered mental status.

Publication types

  • Case Reports