Neurological manifestations of inflammatory multisystem syndrome temporally associated with COVID 19 in Pediatric intensive care unit

Background: Patients under the age of 21 who present with a high temperature, inflammatory markers in the lab, and a severe illness that necessitates hospitalization due to involvement of multiple systems (such as the cardiovascular, renal, respiratory, hematologic, gastrointestinal, dermatologic, or neurological systems) and no other probable diagnoses; or who have recently been infected with SARS-CoV-2 (COVID-19) as confirmed by RT-PCR, serology, or antigen testing; or who have been exposed to COVID-19 without suspecting any other possible diagnosis. Aim: to analyze COVID-19 associated MIS-C by recognizing its signs, symptoms (particularly neurological manifestations), investigation, treatment, and prognosis. Methods: This study focuses on children with neurological symptoms to better understand MIS- C's etiology, symptoms, diagnosis, and prognosis in Beni-Suef university hospital Pediatrics ICU. 39 kids was included Results: This study evaluated the signs, symptoms, investigation, therapy, and prognosis of MIS-C in COVID-19-infected children. 14 women (37.5%) and 25 males (62.5%) were included. Their ages ranged from 1.5 to 180 months, with a mean of 52.5 months. The average duration of stay was 9.1 days, ranging from 1 to 22 days. This study of ( 39 ) individuals showed that Misc patients commonly have problems in other organ systems. The neurological manifestation amonge studied patients showed that (30) case suffered from convulsion of different types, ( 6 ) cases suffered from headache , (20) case ssuffered from encephalopathy, ( 2) cases had acute flaccid paralysis and only one case suffred from acute cerebellar ataxia . 77% of patients have respiratory symptoms (cough, dysnea, cyanosis), 42% have gastrointestinal symptoms (vomiting, diarrhoea, abdominal pain), 30% have cardiac symptoms (shock and hypotension), and 17.5% have renal symptoms (hypertension, oedema, oligiurea). Conclusions The neurological manifestation amonge MIS-C patients are very common including convulsions of different types , headache , encephalopathy, ataxia , acute flaccid paralysis and we notice that , patients with more sever neurological manifestations and had more than 2 organ system affections had poor prognosis (morbidity and mortality) while patients received early treatment IVIG and methyel prednsilone had better prognosis.