1. COVID-19-associated myoclonus in a series of five critically ill patients
- Author
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Marianna Traugott, Christoph Wenisch, Tamara Seitz, Erich Pawelka, Alexander Grieb, Sebastian Baumgartner, Manfred Schmidbauer, Reinhard Kitzberger, Mario Karolyi, Georg Strasser, Stephanie Neuhold, Karolina Knibbe, Alexander Zoufaly, Wolfgang Hoepler, and Hermann Laferl
- Subjects
Myoclonus ,Pediatrics ,medicine.medical_specialty ,Movement disorders ,Critical Illness ,Sedation ,Disease ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,Intensive care ,Humans ,Medicine ,030212 general & internal medicine ,Respiratory system ,Case series ,SARS-CoV-2 ,business.industry ,COVID-19 ,General Medicine ,Hypoxia (medical) ,Intensive Care Units ,SARS-CoV‑2 ,Cohort ,Original Article ,medicine.symptom ,business - Abstract
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.
- Published
- 2021
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