Table 2.

Seven patients with inflammatory, non-inflammatory or autoimmune encephalopathy, including two patients with known multiple sclerosis (MS), and one patient with transverse myelitis.

Patient	27 (Figure 2)	21 (Figure 2)	22	5	9	8	14
Age, M/F, ethnicity, COVID-19 diagnosis	68, F, White, Definite	79, F, White, Definite	46, M, Asian, Definite	69, M, White, Probable	55, F, White, Definite	65, M, White, Definite	56, M, White, Definite
Final neurological diagnosis (impression)	Acute demyelinating encephalomyelitis (ADEM)	Limbic encephalitis associated with SARS-CoV2	Inflammatory encephalopathy associated with SARS-CoV2	Transverse myelitis	Non-inflammatory encephalopathy associated with SARS-CoV2	Relapse in an advanced Secondary Progressive MS	Relapse in a known Multiple Sclerosis
Key neurological signs	Delirium, limb weakness, ataxia, visual hallucination,	Delirium, New onset generalized seizure/status epilepticus, dysphagia, cognitive impairment, amnesia	Delirium, New onset generalized seizures, disinhibition and cognitive impairment	Quadriparesis and sensory loss at cervical level	Headache, delirium, reduced conscious level, confusion and behavioral change	Delirium, reduced consciousness	Worsening limb weakness and dysarthria
Blood results at admission	Hemoglobin 124 g/l Lymphocyte count 0.55 Neutrophil count 9.11 Platelet count 336 CRP 262 mg/L ESR 10 mm/hr D-dimer; NR Ferritin; NR Creatinine 94 umol/L PT 10 s	Hemoglobin 132 g/l Lymphocyte count 0.39 Neutrophil count 5.83 Platelet count 313 CRP 31 mg/L D-dimer 3748 ug/l Ferritin; NR Creatinine 65 umol/L PT 13.7 s	Hemoglobin 147 g/l Lymphocyte count 0.89 Neutrophil count 3.6 Platelet count 133 CRP 149 mg/L ESR 90 mm/hr D-dimer 1659 ug/l Ferritin; 1328 ug/l Creatinine 88 umol/L PT 11.9 s	Hemoglobin 120 g/l Lymphocyte count 1.1 Neutrophil count 8.9 Platelet count 407 CRP 24 mg/L D-dimer; NR Ferritin; NR Creatinine 53 umol/L PT; NT	Hemoglobin 132 g/l Lymphocyte count 1 Neutrophil count 9.1 Platelet count 203 CRP 47 mg/L D-dimer; NR Ferritin; NR Creatinine 67 umol/L PT; NR	Hemoglobin 147 g/l Lymphocyte count 0.46 Neutrophil count 6.4 Platelet count 154 CRP 168 mg/L D-dimer 3748 ug/l Ferritin; NR Creatinine 69 umol/L PT 10.4 s	Hemoglobin 132 g/l Lymphocyte count 0.76 Neutrophil count 3.67 Platelet count 153 CRP 62 mg/L D-dimer 5422 ug/l Ferritin 381 ug/l Creatinine 64 umol/L PT 11.2 s
Brain imaging	MRI; Multiple patchy, asymmetric periventricular and subcortical white matter lesions in bilateral cerebral hemispheres, midbrain, dorsal pons, right middle cerebellar peduncle, medulla and right cerebellar hemisphere. Mixed diffusivity exhibited. Radiological progression on subsequent imaging during hospital admission	MRI; Lesions in the limbic system, predominantly in the left amygdala and hippocampus with partial restricted diffusion	MRI; White matter lesions in the left anterior limbic structures with foci of increased diffusivity suggesting cellular inflammation	MRI; Restricted diffusion in the inferior medulla with enhancement. Small area of restricted diffusion in left middle cerebellar peduncle. MRI spine; Extensive spinal cord abnormality predominantly involving the cervical and lower thoracic regions including the conus in keeping with transverse myelitis	MRI; No acute abnormality. Marked parenchymal atrophy with medial bitemporal predominance	CT: No acute abnormality	MRI: Progression of inflammatory demyelinating plaques since 2015
CSF examination	White cells 3 per μl (first day of admission), White cells 8 lymphocytes per μl (14 days after admission), red cells 1, protein 45.1 mg/dl, glucose 4.1, Paired serum glucose 5.6 mmol/L. Oligoclonal bands present. Viral PCR for SARS-CoV-2/enterovirus/HSV negative. NMDA-R/CASPR2/LGi-1/Glycine receptor antibodies all negative, paraneoplastic anti-neuronal antibodies negative, anti-MOG and AQP4 negative	White cell none, Red cells 9, protein; protein 340 mg/dl, glucose 4.1, Paired serum glucose 5.4 mmol/L. Oligoclonal bands negative. Viral PCR for SARS-CoV-2/enterovirus /HSV negative. NMDA-R/CASPR2/LGi-1/Glycine receptor antibodies all negative, paraneoplastic anti-neuronal antibodies negative	White cell none, Red cells 25, protein 98.7 mg/dl, glucose 4.5, Paired serum glucose 5.8 mmol/L. Oligoclonal bands present. Viral PCR for SARS-CoV-2/enterovirus /HSV negative. NMDA-R/CASPR2/LGi-1/Glycine receptor antibodies all negative, paraneoplastic anti-neuronal antibodies negative	White cell 1, red cells 0, protein 51.4 mg/dl, glucose 3.1 mmol/L. Oligoclonal bands present (identical to serum). Viral PCR for SARS-CoV-2/enterovirus /HSV negative. NMDA-R/CASPR2/LGi-1/Glycine receptor antibodies all negative, paraneoplastic anti-neuronal antibodies negative	Not performed (known early-onset advanced Alzheimer's Dementia with further cognitive decline)	Not performed	Not performed
Neurological treatments; recovery	Corticosteroids; Intravenous Methylprednisolone	Benzodiazepine, Levetiracetam IV & maintenance	Intubation and sedation for status epilepticus, Empirical aciclovir, antibiotics until CSF results available. IV valproate & maintenance	Intravenous Methylprednisolone	Supportive	Supportive and antibiotics (due to advanced disorder, osteomyelitis and pressure sores)	Glatiramer acetate injections 3 times/weekly
Outcome status	Recovery with mild neurological deficits; mRS 1	Partial recovery with mild neurological deficits; mRS 1	Full clinical recovery	Partial recovery with neurological deficits; Moderate disability mRS 4	Partial recovery with neurological deficits; Severe disability mRS 5	Died	Partial recovery with moderate disability; mRS 3

M, male; F, female; NR, no result; CRP, C-Reactive protein; mRS, modified Rankin Score; ESR, Erythrocyte sedimentation rate; PCR, polymerase chain reaction; NMDA-R, N-methyl-D-aspartate Receptor antibodies; LGi-1, Leucine-rich glioma inactivated-1; CASPR2, contactin-associate protein-like 2; MOG, myelin oligodendrocyte glycoprotein; AQP4, Aquaporin-4; PT, Prothrombin time. Paraneoplastic anti-neuronal antibodies including GABA-B; γ-Aminobutyric acid-B receptor; AMPA; GluR1 and GluR2 subunits of the AMPA receptor. CT, computed tomography. MRI, magnetic resonance imaging, Lymphocyte, neutrophil and platelet count, numbers x 10 E9/L. The bold values highlight abnormal values.