{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T05:07:25Z","timestamp":1788930445811,"version":"build-2803163510"},"reference-count":80,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Pers. Med.","JPM"],"abstract":"<jats:p>Background: Pediatric inflammatory multisystem syndrome (PIMS), also referred to as multisystem inflammatory syndrome in children (MIS-C), is a rare but serious post-infectious complication of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection characterized by systemic hyperinflammation and multiorgan involvement. New-onset neurological and psychiatric symptoms have emerged as critical clinical features, occurring in approximately 12\u201327% of pediatric patients aged 2\u201315 years (median age, 10 years) and often indicating a more severe disease course. This narrative review aims to provide a comprehensive overview of the current literature regarding the neurological and psychiatric manifestations of PIMS\/MIS-C, focusing on epidemiology, pathophysiology, clinical presentation, neuroimaging findings, biomarkers, treatment strategies, and outcomes. Methods: A narrative literature review was conducted to synthesize current evidence on the neurological and psychiatric spectrum of PIMS\/MIS-C. Evaluated parameters included clinical presentations ranging from common symptoms (such as headache, encephalopathy, altered mental status, and seizures) to rare complications (such as ischemic stroke, acute disseminated encephalomyelitis, Guillain\u2013Barr\u00e9 syndrome, and cerebral edema), alongside associated psychiatric disturbances, diagnostic findings, and therapeutic approaches. Results: Neurological and psychiatric manifestations significantly impact the clinical trajectory of PIMS\/MIS-C. Acute symptoms include headache, encephalopathy, seizures, and psychiatric disturbances like behavioral changes, hallucinations, delirium, anxiety, and sleep disorders. Neuroimaging in many cases reveals reversible lesions of the splenium of the corpus callosum, while electroencephalography typically demonstrates diffuse slowing consistent with encephalopathy. Early recognition and prompt administration of immunomodulatory therapy\u2014primarily intravenous immunoglobulin and corticosteroids\u2014correlate with favorable neurological recovery in the majority of patients. However, current evidence remains largely observational and heterogeneous, precluding definitive causal conclusions regarding this treatment\u2013outcome relationship. Affected children more frequently require intensive care unit admission and remain at risk for persistent cognitive, behavioral, and psychiatric sequelae. Conclusions: Neurological and psychiatric complications in PIMS\/MIS-C are clinically significant indicators of disease severity that require vigilant monitoring and early immunomodulatory intervention. Continued multidisciplinary follow-up and prospective studies are essential to elucidate the long-term neurodevelopmental and psychiatric consequences and to optimize therapeutic strategies for these patients.<\/jats:p>","DOI":"10.3390\/jpm16090461","type":"journal-article","created":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T03:19:26Z","timestamp":1788232766000},"page":"461","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Neurological and Neuropsychiatric Manifestations of Pediatric Inflammatory Multisystem Syndrome (PIMS\/MIS-C): A Narrative Review"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-3584-9776","authenticated-orcid":false,"given":"Wiktor","family":"\u015aliwi\u0144ski","sequence":"first","affiliation":[{"name":"The Independent Public Healthcare Institution of the Ministry of the Interior and Administration in Lodz, P\u00f3\u0142nocna 42, 91-425 Lodz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-2889-667X","authenticated-orcid":false,"given":"Weronika","family":"Pura","sequence":"additional","affiliation":[{"name":"The Independent Public Healthcare Institution of the Ministry of the Interior and Administration in Lodz, P\u00f3\u0142nocna 42, 91-425 Lodz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-4644-5943","authenticated-orcid":false,"given":"Dominika","family":"Matecka","sequence":"additional","affiliation":[{"name":"Jozef Strus Municipal Hospital, A Multispecialty Medical Centre in Poznan Szwajcarska Street, 61-285 Poznan, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-0811-5326","authenticated-orcid":false,"given":"Mateusz","family":"Kosowski","sequence":"additional","affiliation":[{"name":"Independent Public Healthcare Institution in Kolo, 25 Ksiecia Jozefa Poniatowskiego Street, 62-600 Kolo, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-1445-6336","authenticated-orcid":false,"given":"Daniel","family":"Cho\u0142uj","sequence":"additional","affiliation":[{"name":"The Independent Public Healthcare Institution of the Ministry of the Interior and Administration in Lodz, P\u00f3\u0142nocna 42, 91-425 Lodz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-5675-6963","authenticated-orcid":false,"given":"Jakub","family":"Marciniak","sequence":"additional","affiliation":[{"name":"University Clinical Hospital No. 2 of the Medical University of \u0141odz, 113 Zeromskiego Street, 90-549 Lodz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-1089-9210","authenticated-orcid":false,"given":"Jakub","family":"Mazur","sequence":"additional","affiliation":[{"name":"Voivodeship Combined Hospital in Kielce, 45 Grunwaldzka Street, 25-736 Kielce, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-6066-7667","authenticated-orcid":false,"given":"Karolina","family":"Zar\u00f3wna","sequence":"additional","affiliation":[{"name":"District Hospital Complex in Olesnica, 1 Armii Krajowej Street, 56-400 Olesnica, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laavanya","family":"Damodaran","sequence":"additional","affiliation":[{"name":"Birmingham Children\u2019s Hospital, Birmingham B4 6NH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalia","family":"Szejko","sequence":"additional","affiliation":[{"name":"Clinic of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, 30625 Hannover, Germany"},{"name":"Department of Child Psychiatry, Babinski Hospital, 91-229 Lodz, Poland"},{"name":"Department of Health Sociology, Education and Medical Communication, Institute of Mother and Child, 01-211 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,31]]},"reference":[{"key":"ref_1","unstructured":"(2026, August 19). 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