Skip to main content
main-content

Tipp

Weitere Artikel dieser Ausgabe durch Wischen aufrufen

Erschienen in: Wiener klinische Wochenschrift 17-18/2021

15.06.2021 | original article

COVID-19-associated myoclonus in a series of five critically ill patients

verfasst von: BScMed Alexander Grieb, Tamara Seitz, Reinhard Kitzberger, Manfred Schmidbauer, Wolfgang Hoepler, Sebastian Baumgartner, Marianna T. Traugott, Erich Pawelka, Mario Karolyi, Georg Strasser, Karolina Knibbe, Hermann Laferl, Alexander Zoufaly, Christoph Wenisch, Stephanie Neuhold

Erschienen in: Wiener klinische Wochenschrift | Ausgabe 17-18/2021

Einloggen, um Zugang zu erhalten
share
TEILEN

Summary

Background

In addition to respiratory symptoms, many patients with coronavirus disease 2019 (COVID-19) present with neurological complications. Several case reports and small case series described myoclonus in five patients suffering from the disease. The purpose of this article is to report on five critically ill patients with COVID-19-associated myoclonus.

Material and methods

The clinical courses and test results of patients treated in the study center ICU and those of partner hospitals are described. Imaging, laboratory tests and electrophysiological test results are reviewed and discussed.

Results

In severe cases of COVID-19 myoclonus can manifest about 3 weeks after initial onset of symptoms. Sedation is sometimes effective for symptom control but impedes respiratory weaning. No viral particles or structural lesions explaining this phenomenon were found in this cohort.

Conclusion

Myoclonus in patients with severe COVID-19 may be due to an inflammatory process, hypoxia or GABAergic impairment. Most patients received treatment with antiepileptic or anti-inflammatory agents and improved clinically.
Literatur
1.
Zurück zum Zitat Vaira LA, Salzano G, Deiana G, de Riu G. Anosmia and Ageusia: common findings in COVID-19 patients. Laryngoscope. 2020;130(7):1787. CrossRef Vaira LA, Salzano G, Deiana G, de Riu G. Anosmia and Ageusia: common findings in COVID-19 patients. Laryngoscope. 2020;130(7):1787. CrossRef
2.
Zurück zum Zitat Mao L, Wang M, Chen S, He Q, Chang J, Hong C, et al. Neurological manifestations of hospitalized patients with COVID-19 in Wuhan, China: a retrospective case series study. 2020. Mao L, Wang M, Chen S, He Q, Chang J, Hong C, et al. Neurological manifestations of hospitalized patients with COVID-19 in Wuhan, China: a retrospective case series study. 2020.
4.
Zurück zum Zitat Oxley TJ, Mocco J, Majidi S, Kellner CP, Shoirah H, Singh IP, et al. Large-vessel stroke as a presenting feature of Covid-19 in the young. N Engl J Med. 2020;382(20):e60. CrossRef Oxley TJ, Mocco J, Majidi S, Kellner CP, Shoirah H, Singh IP, et al. Large-vessel stroke as a presenting feature of Covid-19 in the young. N Engl J Med. 2020;382(20):e60. CrossRef
5.
Zurück zum Zitat Ellul MA, Benjamin L, Singh B, Lant S, Michael BD, Easton A, et al. Neurological associations of COVID-19. Lancet Neurol. 2020;19(9):767–83. CrossRef Ellul MA, Benjamin L, Singh B, Lant S, Michael BD, Easton A, et al. Neurological associations of COVID-19. Lancet Neurol. 2020;19(9):767–83. CrossRef
6.
Zurück zum Zitat Gutiérrez-Ortiz C, Méndez-Guerrero A, Rodrigo-Rey S, San Pedro-Murillo E, Bermejo-Guerrero L, Gordo-Mañas R, et al. Miller Fisher syndrome and polyneuritis cranialis in COVID-19. Neurology. 2020;95(5):e601–e5. CrossRef Gutiérrez-Ortiz C, Méndez-Guerrero A, Rodrigo-Rey S, San Pedro-Murillo E, Bermejo-Guerrero L, Gordo-Mañas R, et al. Miller Fisher syndrome and polyneuritis cranialis in COVID-19. Neurology. 2020;95(5):e601–e5. CrossRef
8.
Zurück zum Zitat Asadi-Pooya AA, Simani L. Central nervous system manifestations of COVID-19: A systematic review. J Neurol Sci. 2020;413:116832. CrossRef Asadi-Pooya AA, Simani L. Central nervous system manifestations of COVID-19: A systematic review. J Neurol Sci. 2020;413:116832. CrossRef
12.
Zurück zum Zitat Anand P, Zakaria A, Benameur K, Ong C, Putman M, O’Shea S, et al. Myoclonus in patients with Coronavirus disease 2019: a multicenter case series. Crit Care Med. 2020;48(11):1664–9. CrossRef Anand P, Zakaria A, Benameur K, Ong C, Putman M, O’Shea S, et al. Myoclonus in patients with Coronavirus disease 2019: a multicenter case series. Crit Care Med. 2020;48(11):1664–9. CrossRef
13.
Zurück zum Zitat Cuhna P, Herlin B, Vassilev K, Kas A, Lehericy S, Worbe Y, et al. Movement disorders as a new neurological clinical picture in severe SARS-CoV‑2 infection. Eur J Neurol. 2020;27(12):e88–e90. CrossRef Cuhna P, Herlin B, Vassilev K, Kas A, Lehericy S, Worbe Y, et al. Movement disorders as a new neurological clinical picture in severe SARS-CoV‑2 infection. Eur J Neurol. 2020;27(12):e88–e90. CrossRef
15.
Zurück zum Zitat Versace V, Sebastianelli L, Ferrazzoli D, Romanello R, Ortelli P, Saltuari L, et al. Intracortical GABAergic dysfunction in patients with fatigue and dysexecutive syndrome after COVID-19. Clin Neurophysiol. 2021;132(5):1138–43. CrossRef Versace V, Sebastianelli L, Ferrazzoli D, Romanello R, Ortelli P, Saltuari L, et al. Intracortical GABAergic dysfunction in patients with fatigue and dysexecutive syndrome after COVID-19. Clin Neurophysiol. 2021;132(5):1138–43. CrossRef
16.
Zurück zum Zitat Ortelli P, Ferrazzoli D, Sebastianelli L, Engl M, Romanello R, Nardone R, et al. Neuropsychological and neurophysiological correlates of fatigue in post-acute patients with neurological manifestations of COVID-19: Insights into a challenging symptom. J Neurol Sci. 2021;420:117271. CrossRef Ortelli P, Ferrazzoli D, Sebastianelli L, Engl M, Romanello R, Nardone R, et al. Neuropsychological and neurophysiological correlates of fatigue in post-acute patients with neurological manifestations of COVID-19: Insights into a challenging symptom. J Neurol Sci. 2021;420:117271. CrossRef
17.
Zurück zum Zitat Grimaldi S, Lagarde S, Harlé J‑R, Boucraut J, Guedj E. Autoimmune encephalitis concomitant with SARS-coV‑2 infection: insight from 18F-FDG PET imaging and neuronal autoantibodies. J Nucl Med. 2020;61(12):1726–9. CrossRef Grimaldi S, Lagarde S, Harlé J‑R, Boucraut J, Guedj E. Autoimmune encephalitis concomitant with SARS-coV‑2 infection: insight from 18F-FDG PET imaging and neuronal autoantibodies. J Nucl Med. 2020;61(12):1726–9. CrossRef
Metadaten
Titel
COVID-19-associated myoclonus in a series of five critically ill patients
verfasst von
BScMed Alexander Grieb
Tamara Seitz
Reinhard Kitzberger
Manfred Schmidbauer
Wolfgang Hoepler
Sebastian Baumgartner
Marianna T. Traugott
Erich Pawelka
Mario Karolyi
Georg Strasser
Karolina Knibbe
Hermann Laferl
Alexander Zoufaly
Christoph Wenisch
Stephanie Neuhold
Publikationsdatum
15.06.2021
Verlag
Springer Vienna
Erschienen in
Wiener klinische Wochenschrift / Ausgabe 17-18/2021
Print ISSN: 0043-5325
Elektronische ISSN: 1613-7671
DOI
https://doi.org/10.1007/s00508-021-01890-3