Myoclonus in Patients With Coronavirus Disease 2019: A Multicenter Case Series

被引:32
作者
Anand, Pria [1 ]
Zakaria, Asma [2 ]
Benameur, Karima [3 ]
Ong, Charlene [1 ]
Putman, Maryann [3 ]
O'Shea, Sarah [1 ]
Greer, David [1 ]
Cervantes-Arslanian, Anna M. [1 ,4 ,5 ]
机构
[1] Boston Univ, Med Ctr, Dept Neurol, Boston, MA 02215 USA
[2] INOVA Fairfax Med Campus, Crit Care Med, Falls Church, VA USA
[3] Emory Univ, Sch Med, Dept Neurol, Atlanta, GA 30322 USA
[4] Boston Univ, Med Ctr, Dept Med Infect Dis, Boston, MA 02215 USA
[5] Boston Univ, Med Ctr, Dept Neurosurg, Boston, MA 02215 USA
关键词
coronavirus disease 2019; myoclonus; neurocritical care; neuroinfectious diseases; RESPIRATORY SYNDROME CORONAVIRUS; INFECTION; DIAGNOSIS;
D O I
10.1097/CCM.0000000000004570
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Objectives: To describe the risk factors for and outcomes after myoclonus in a cohort of patients with coronavirus disease 2019. Design: Multicenter case series. Setting: Three tertiary care hospitals in Massachusetts, Georgia, and Virginia. Patients: Eight patients with clinical myoclonus in the setting of coronavirus disease 2019. Interventions & Measurements and Main Results: Outcomes in patients with myoclonus were variable, with one patient who died during the study period and five who were successfully extubated cognitively intact and without focal neurologic deficits. In five cases, the myoclonus completely resolved within 2 days of onset, while in three cases, it persisted for 10 days or longer. Seven patients experienced significant metabolic derangements, hypoxemia, or exposure to sedating medications that may have contributed to the development of myoclonus. One patient presented with encephalopathy and developed prolonged myoclonus in the absence of clear systemic provoking factors. Conclusions: Our findings suggest that myoclonus may be observed in severe acute respiratory syndrome coronavirus 2 infected patients, even in the absence of hypoxia. This association warrants further evaluation in larger cohorts to determine whether the presence of myoclonus may aid in the assessment of disease severity, neurologic involvement, or prognostication.
引用
收藏
页码:1664 / 1669
页数:6
相关论文
共 23 条
[1]   Encephalopathy and Encephalitis Associated with Cerebrospinal Fluid Cytokine Alterations and Coronavirus Disease, Atlanta, Georgia, USA, 2020 [J].
Benameur, Karima ;
Agarwal, Ankita ;
Auld, Sara C. ;
Butters, Matthew P. ;
Webster, Andrew S. ;
Ozturk, Tugba ;
Howell, J. Christina ;
Bassit, Leda C. ;
Velasquez, Alvaro ;
Schinazi, Raymond F. ;
Mullins, Mark E. ;
Hu, William T. .
EMERGING INFECTIOUS DISEASES, 2020, 26 (09) :2016-2021
[2]   Acute posthypoxic myoclonus after cardiopulmonary resuscitation [J].
Bouwes, Aline ;
van Poppelen, Daniel ;
Koelman, Johannes H. T. M. ;
Kuiper, Michael A. ;
Zandstra, Durk F. ;
Weinstein, Henry C. ;
Tromp, Selma C. ;
Zandbergen, Eveline G. J. ;
Tijssen, Marina A. J. ;
Horn, Janneke .
BMC NEUROLOGY, 2012, 12
[3]  
Cascella M., 2020, FEATURES EVALUATION
[4]   Meningoencephalitis without respiratory failure in a young female patient with COVID-19 infection in Downtown Los Angeles, early April 2020 [J].
Duong, Lisa ;
Xu, Prissilla ;
Liu, Antonio .
BRAIN BEHAVIOR AND IMMUNITY, 2020, 87 :33-33
[5]   Clinically Distinct Electroencephalographic Phenotypes of Early Myoclonus after Cardiac Arrest [J].
Elmer, Jonathan ;
Rittenberger, Jon C. ;
Faro, John ;
Molyneaux, Bradley J. ;
Popescu, Alexandra ;
Callaway, Clifton W. ;
Baldwin, Maria .
ANNALS OF NEUROLOGY, 2016, 80 (02) :175-184
[6]  
Freund B, 2017, CLIN NEUROPHYS PRACT, V2, P98, DOI 10.1016/j.cnp.2017.03.003
[7]   Clinical Characteristics of Coronavirus Disease 2019 in China [J].
Guan, W. ;
Ni, Z. ;
Hu, Yu ;
Liang, W. ;
Ou, C. ;
He, J. ;
Liu, L. ;
Shan, H. ;
Lei, C. ;
Hui, D. S. C. ;
Du, B. ;
Li, L. ;
Zeng, G. ;
Yuen, K. -Y. ;
Chen, R. ;
Tang, C. ;
Wang, T. ;
Chen, P. ;
Xiang, J. ;
Li, S. ;
Wang, Jin-lin ;
Liang, Z. ;
Peng, Y. ;
Wei, L. ;
Liu, Y. ;
Hu, Ya-hua ;
Peng, P. ;
Wang, Jian-ming ;
Liu, J. ;
Chen, Z. ;
Li, G. ;
Zheng, Z. ;
Qiu, S. ;
Luo, J. ;
Ye, C. ;
Zhu, S. ;
Zhong, N. .
NEW ENGLAND JOURNAL OF MEDICINE, 2020, 382 (18) :1708-1720
[8]  
Hong X, 2020, ANAL EARLY RENAL INJ
[9]   SYNDROME OF INTENTION OR ACTION MYOCLONUS AS A SEQUEL TO HYPOXIC ENCEPHALOPATHY [J].
LANCE, JW ;
ADAMS, RD .
BRAIN, 1963, 86 (01) :111-&
[10]   Acute cerebrovascular disease following COVID-19: a single center, retrospective, observational study [J].
Li, Yanan ;
Li, Man ;
Wang, Mengdie ;
Zhou, Yifan ;
Chang, Jiang ;
Xian, Ying ;
Wang, David ;
Mao, Ling ;
Jin, Huijuan ;
Hu, Bo .
STROKE AND VASCULAR NEUROLOGY, 2020, 5 (03) :279-284