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University Education

Patient no.	Onset of neurologic symptoms	Neurologic Signs & Symptoms
1	On Admission	Respiratory distress, fever, and altered mental status
2	On Admission	fever, slurring of speech, facial droop, and reduced oral intake
3	On Admission	Left sided weakness, altered mental weakness, one week history of frequent falls
4	On Admission	An 15 minute episode of weakness and numbness of right arm and word finding difficulty
5	7 days after cough,ageusia and anosmia	facial weakness,flaccid areflexic paraplegia(day 2-3) and respiratory failure (day 4)

University Education

Syncope is classified yo three categories:

• Vasovagal
• Neurogenic
• Cardiovascular.

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Case courtesy of Dr Subhan Iqbal, Radiopaedia.org, rID: 76341

DDx of syncope

Patient	Past Medical History	Later presentation	GCS	Lab. Findings		Specific Tests	Imaging studies
				CBC	CSF		MRI/CT scan
1. 84-year old man in France presented with dyspnea and cough	Diabetes Mellitus, Hypertension, Atrial fibrillation, Peripheral Arterial Disease, Coronary Heart Disease	Worsening headache, Sore throat. (Day 5) Impaired consciousness and transient generalized seizure, (Day 9)	E4V1M1	↑WBCs and neutrophils ↓lymphocytes ↑ CRP	Clear and colorless fluid, Pressure=320 mmH2O, Cell count was 12/μL–10 mononuclear and 2 polymorphonuclear cells	RT-PCR for SARS-CoV-2 was positive in nasopharyngeal swab	Brain MRI: Hyperintensity in the right lateral ventricle's inferior horn along the wall, pan-paranasal sinusitis.
2. 74-year old man in France presented with confusion and influenza-like illness	Flu like symptoms	Headache, nausea, dizziness, and drug-refractory seizures.	E4V5M6	NA	NA	RT-PCR and antibody tests positive	Brain MRI: Hyperintensity in the left temporal lobe. MR Spectroscopy: Decrease N-acetyl aspartate peak along with a marked elevated choline peak.
3. 31-year-old African American woman	SCD patient with dyspnea	Paralysis and sedation (Day 13) Comatose (Day 15) and death (Day 16)	E0V0M0	NA	Pressure=30cmH2O 115 nucleated cell /ml 7374 erythrocytes /ml Protein> 200mg/dl	RT=PCR for SARS-CoV-2 was positive in nasopharyngeal swab	Brain MRI: Nonenhancing cerebral edema and restricted diffusion in the right cerebral hemisphere with brain herniation.