Generalized myoclonus in COVID-19

Autor: Judit Gutiérrez-Gutiérrez, Daniel Toledo-Alfocea, Teresa Santos-Fernández, Antonio Méndez-Guerrero, Jesús González de la Aleja, Laura Bermejo-Guerrero, Daniel Sánchez-Tejerina, María Dolores Folgueira-López, Julián Benito-León, Blanca Ayuso-García, Javier Parra-Serrano, Pablo Rábano-Suárez
Rok vydání: 2020
Předmět:
Zdroj: European Journal of Neurology
ISSN: 1526-632X
0028-3878
Popis: ObjectiveTo report 3 patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) who developed generalized myoclonus.MethodsPatient data were obtained from medical records from the University Hospital “12 de Octubre,” Madrid, Spain.ResultsThree patients (2 men and 1 woman, aged 63–88 years) presented with mild hypersomnia and generalized myoclonus following the onset of the so-called inflammatory phase of coronavirus disease 2019 (COVID-19). All of them had presented previously with anosmia. Myoclonus was generalized with both positive and negative jerks, predominantly involving the facial, trapezius, sternocleidomastoid, and upper extremities muscles. These myoclonic jerks occurred spontaneously and were extremely sensitive to multisensory stimuli (auditive and tactile) or voluntary movements, with an exaggerated startle response. Other causes of myoclonus were ruled out, and none of the patients had undergone respiratory arrest or significant prolonged hypoxia. All of them improved, at least partially, with immunotherapy.ConclusionsOur 3 cases highlight the occurrence of myoclonus during the COVID-19 pandemic as a post- or para-infectious immune-mediated disorder. However, we cannot rule out that SARS-CoV-2 may spread transneuronally to first- and second-order structures connected with the olfactory bulb. Further investigation is required to clarify the full clinical spectrum of neurologic symptoms and optimal treatment.
Databáze: OpenAIRE