AIIMS reports first case of Covid-19-related brain nerve damage in a child

The New Delhi-based All India Institute of Medical Sciences (AIIMS) has reported its first coronavirus disease (Covid-19)-induced brain nerve damage in a girl (11), which has led to her blurred vision.

The doctors in the child neurology division are preparing a report on her health condition that they plan to publish soon.

“We have found Covid-19 infection-induced Acute Demyelinating Syndrome (ADS) in an 11-year-old girl. This is the first case that has been reported in the paediatric age group,” said the draft of the report.

The nerves are covered with a protective layer called myelin that helps messages from the brain move quickly and smoothly through the body.

ADS include health conditions that damage myelin, brain signals and affect a gamut of neurological functions such as vision, muscle movement, senses, bladder and bowel movement etc.

“This girl had come to us with a loss of vision. The MRI (magnetic resonance imaging) showed ADS, which is a new manifestation. However, we now know that the virus majorly affects the brain and the lungs. We plan to publish this case report since we have established that her condition was Covid-19 induced,” said Dr Sheffali Gulati, chief, child neurology division, department of paediatrics, AIIMS, Delhi.

The girl was undergoing treatment under Dr Gulati’s supervision. Her condition improved with immunotherapy, and she was discharged from the hospital after about 50% of her vision was regained.

AIIMS authorities are also treating another Covid-19-positive teenager (13) girl after she had complained of fever and encephalopathy (swelling of brain). She is undergoing treatment and the doctors are still trying to ascertain whether her condition was induced by Covid-19.

Epilepsy, encephalitis, Kawasaki-like disease, Guillain-barre syndrome etc are the other commonplace health complications that children, who tested Covid-19 positive, are known to suffer from.

Some of these brain conditions may adversely affect the long-term neurodevelopmental outcome. As a result, these children need a regular follow-up treatment that can be a challenge for a resource-strapped country such as India.

In a review published in the journal Pediatric Neurology, Dr Gulati, said, “…the challenges faced by paediatric neurologists in a developing country are distinctive. Only a few centres, including ours, run round-the-clock child neurology tele-helpline and tele-consultation services, but restricted availability of video-calls and internet facility at rural households limits their efficient use. Besides, specialised facilities such as dietary therapy and surgery for drug-refractory epilepsy, etc. are offered at only a few centres only.”

The treatment gap for neurological disorders is going to increase in India in the near future.

“We can sense the problem, as our telemedicine helpline meant for children with neurological issues is receiving around 25 calls a day on an average, as compared to about 10 calls earlier. This is going to be a huge problem, as we are also treating non-Covid-19 children with neurological conditions, who need immediate attention. Our healthcare workers on the ground need to undergo training to identify neurodevelopment issues among children, promoting tele-consultation in a bid the public can at least call with their problems etc. We cannot talk of allotting more funds because of the prevailing situation, but it needs more thought,” Dr Gulati added.

HT