Vol 55, No 3 (2021)
Short Communication
Published online: 2021-04-26

open access

Page views 2169
Article views/downloads 1870
Get Citation

Connect on Social Media

Connect on Social Media

Two COVID-19-related video-accompanied cases of severe ataxia-myoclonus syndrome

Filip Przytuła1, Szymon Błądek2, Jarosław Sławek13
Pubmed: 34096013
Neurol Neurochir Pol 2021;55(3):310-313.

Abstract

Aim of the study. The pandemic state of COVID-19 has resulted in new neurological post-infection syndromes. Recently, several papers have reported ataxia-myoclonus syndrome following SARS-CoV-2 infection. The aim of this study was to present our two cases and compare them to previously reported cases. Materials and methods. We present two video-accompanied new cases with ataxia-myoclonus syndrome following SARS-CoV-2 infection and discuss the studies published so far. Results. Ataxia-myoclonus syndrome, isolated myoclonus, opsoclonus-myoclonus syndrome as post-COVID-19 syndrome following infection have been described in 16 patients (including our two cases). Patients have been treated with intravenous immunoglobulins and/or steroids except for 4 patients, which resulted in a significant improvement within 1–8 weeks. Conclusions and clinical implications. The increasing number of patients with a similar symptomatology shows a significant relationship between COVID-19 infection and ataxia-myoclonus syndrome. The subacute onset of neurological symptoms after a resolved COVID-19 infection and prominent response to immunotherapy may suggest that the neurological manifestations are immune-mediated. Although recovery is highly possible, it may take several weeks/months, and clinicians should be aware of this diagnosis and the beneficial effects of immunological treatment administered as soon as possible.

Article available in PDF format

View PDF Download PDF file

References

  1. Maury A, Lyoubi A, Peiffer-Smadja N, et al. Neurological manifestations associated with SARS-CoV-2 and other coronaviruses: A narrative review for clinicians. Rev Neurol (Paris). 2021; 177(1-2): 51–64.
  2. Słyk S, Domitrz I. Neurological manifestations of SARS-CoV-2 - a systematic review. Neurol Neurochir Pol. 2020; 54(5): 378–383.
  3. Tipton PW, Wszolek ZK. What can Parkinson's disease teach us about COVID-19? Neurol Neurochir Pol. 2020; 54(2): 204–206.
  4. Oh SY, Kim JS, Dieterich M. Update on opsoclonus-myoclonus syndrome in adults. J Neurol. 2019; 266(6): 1541–1548.
  5. Grimaldi S, Lagarde S, Harlé JR, et al. Autoimmune Encephalitis Concomitant with SARS-CoV-2 Infection: Insight from F-FDG PET Imaging and Neuronal Autoantibodies. J Nucl Med. 2020; 61(12): 1726–1729.
  6. Emamikhah M, Babadi M, Mehrabani M, et al. Opsoclonus-myoclonus syndrome, a post-infectious neurologic complication of COVID-19: case series and review of literature. J Neurovirol. 2021; 27(1): 26–34.
  7. Wright D, Rowley R, Halks-Wellstead P, et al. Abnormal Saccadic Oscillations Associated with Severe Acute Respiratory Syndrome Coronavirus 2 Encephalopathy and Ataxia. Mov Disord Clin Pract. 2020; 7(8): 980–982.
  8. Dijkstra F, Van den Bossche T, Willekens B, et al. Myoclonus and cerebellar ataxia following Coronavirus Disease 2019 (COVID-19). Mov Disord Clin Pract. 2020 [Epub ahead of print].
  9. Schellekens MMI, Bleeker-Rovers CP, Keurlings PAJ, et al. Reversible Myoclonus-Ataxia as a Postinfectious Manifestation of COVID-19. Mov Disord Clin Pract. 2020; 7(8): 977–979.
  10. Foucard C, San-Galli A, Tarrano C, et al. Acute cerebellar ataxia and myoclonus with or without opsoclonus: a parainfectious syndrome associated with COVID-19. Eur J Neurol. 2021 [Epub ahead of print].
  11. Shah PB, Desai SD. Opsoclonus Myoclonus Ataxia Syndrome in the Setting of COVID-19 Infection. Neurology. 2021; 96(1): 33.