Brain on fire: neurologic manifestations of COVID

Administrator: Shilpa Kulkarni , India

Dr. Shilpa Kulkarni
Bai Jerbai wadia Hospital for Children
skulkarni.shilpa@gmail.com
Neuroradiological manifestations of COVID and MIS- C
In COVID-19, a variety of neurological complications have been reported. The exact etiopathogenesis of neurological symptoms in COVID-19 is poorly understood. This could be due to critical illness or direct neuroinvasion and neurotropic nature of the virus itself or it could be secondary to post infectious immune reaction . In COVID-19, both the CNS and peripheral nervous system (PNS) are affected. The radiological manifestations were variable . It shoewd acute necrotising encephalopathy , hippocmpal hyperintensity , various microhemorrhages , lekoencephalopthy , demyelination and stroke . The meningeal involvement was not seen The pathophysiology and neuroimmunology of COVID guided the presentation and treatment protocols. Antivirals , immunomodulators , blood thinners , various antibodies , plasma therapy , all were tried in various presentations with variable results . Through the symposium , neuro immunology , pathology and radiological correlations are sought for - helping in specific treatment protocols .

Dr. Vrushabh Gavali
Bai Jerbai wadia Hospital for Children
dr.vrushabhgavali@gmail.com
Clinical presentation of neuro COVID
The talk will encompass various aspects of clinical presentation of Neuro covid . Actual cases and review of variety of neuro COVID will be presented covering all aspects of neurological manifestations , complications of COVID
Central and peripheral nervous system involvement was commonly noted in COVID . Acute encephalopathy - encephalitis , Secondary manifestations secondary to severe cardiorespiratory disturbances with hypoxia , shock , brain damage due to cytokine storm as in MIS-C and a variety of vasculopathic involvement with stroke and hemorrhages , immune encephalitis , demyelination , leukoencephalopathy , ADEM were noted . Status epilepticus , FIRES , acute symptomatic seizures , was one group as against demyelinating was more common in covid related immune dysfunction. 

Dr. Manisha Madkaikar
National Institute of Immuno haematology , ICMR
madkaikarmanisha@yahoo.co.in
Neuro- Immunology simplified : Neuro COVID
The talk will cover the immunological aspect of COVID especially with pathological correlation. COVID is known to cause acute severe lymphopenia leading to viral proliferation but at the same time it can initiate hemolymphohistioctic reaction which can enhance the inflammatory damage to the brain . It can cause immune dysregulation - with a variety of cytokine storm which can lead to severe inflammation of the nervous system leading to major CNS dysfunction. Neurological manifestations are more common in adults , with CNS manifestations in 24% and 8% peripheral nernous system involvement ,. the overall incidence of neurological complications in pediatric population is only 1%
The immunological make up in adult and pediatric covid will be discussed in a short talk . Indian experience of immune dysfunction in COVID would be shared in terms of sero positivity for various antibodies.

Dr. Lokesh Lingappa
Rainbow Children's Hospital
siriloki@gmail.com
Management protocols in neurocovi
Neuro COVID is the recent addition to the variety of CNS and PNS infectious and immune disorders with variety of pathophysiology . There is dearth of knowledge in overall COVID management including adults and more so ever in pediatrics.There are hardly any time tested evidence based guidelines about neuro COVID management and the knowledge is incomplete in terms of long term effects. The protocols are ever changing and evolving depending upon the pathophysiology.
The host immune system makes a major contribution in the clinical manifestations as well as in the treatment decision. Depending on the pathophysiology and clinical presentation the treatment protocols included , corticosteroids , immuno globulins , antiplatelets , heparin , plasmapheresis, plasma therapy , monoclonal antibodies , antivirals. The lecture will cover the recent advances in management of Neuro Covid. It will also c over the outcome of various treatments and prognostication in terms ogf mortality and morbidity.