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Treatment of unexplained coma and hypokinetic-rigid syndrome in a patient with COVID-19

The COVID-19 pandemic has dealt a devastating blow to healthcare systems globally. Approximately 3.2% of patients infected with COVID-19 require invasive ventilation during the course of the illness. Within this population, 25% of patients are affected with neurological manifestations. Among those w...

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Autores principales: Roy, Devjit, Song, Justin, Awad, Nirvana, Zamudio, Paul
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7929831/
https://www.ncbi.nlm.nih.gov/pubmed/33653852
http://dx.doi.org/10.1136/bcr-2020-239781
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author Roy, Devjit
Song, Justin
Awad, Nirvana
Zamudio, Paul
author_facet Roy, Devjit
Song, Justin
Awad, Nirvana
Zamudio, Paul
author_sort Roy, Devjit
collection PubMed
description The COVID-19 pandemic has dealt a devastating blow to healthcare systems globally. Approximately 3.2% of patients infected with COVID-19 require invasive ventilation during the course of the illness. Within this population, 25% of patients are affected with neurological manifestations. Among those who are affected by severe neurological manifestations, some may have acute cerebrovascular complications (5%), impaired consciousness (15%) or exhibit skeletal muscle hypokinesis (20%). The cause of the severe cognitive impairment and hypokinesis is unknown at this time. Potential causes include COVID-19 viral encephalopathy, toxic metabolic encephalopathy, post-intensive care unit syndrome and cerebrovascular pathology. We present a case of a 60 year old patient who sustained a prolonged hospitalization with COVID-19, had a cerebrovascular event and developed a persistent unexplained encephalopathy along with a hypokinetic state. He was treated successfully with modafinil and carbidopa/levodopa showing clinical improvement within 3–7 days and ultimately was able to successfully discharge home.
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spelling pubmed-79298312021-03-19 Treatment of unexplained coma and hypokinetic-rigid syndrome in a patient with COVID-19 Roy, Devjit Song, Justin Awad, Nirvana Zamudio, Paul BMJ Case Rep Case Report The COVID-19 pandemic has dealt a devastating blow to healthcare systems globally. Approximately 3.2% of patients infected with COVID-19 require invasive ventilation during the course of the illness. Within this population, 25% of patients are affected with neurological manifestations. Among those who are affected by severe neurological manifestations, some may have acute cerebrovascular complications (5%), impaired consciousness (15%) or exhibit skeletal muscle hypokinesis (20%). The cause of the severe cognitive impairment and hypokinesis is unknown at this time. Potential causes include COVID-19 viral encephalopathy, toxic metabolic encephalopathy, post-intensive care unit syndrome and cerebrovascular pathology. We present a case of a 60 year old patient who sustained a prolonged hospitalization with COVID-19, had a cerebrovascular event and developed a persistent unexplained encephalopathy along with a hypokinetic state. He was treated successfully with modafinil and carbidopa/levodopa showing clinical improvement within 3–7 days and ultimately was able to successfully discharge home. BMJ Publishing Group 2021-03-02 /pmc/articles/PMC7929831/ /pubmed/33653852 http://dx.doi.org/10.1136/bcr-2020-239781 Text en © BMJ Publishing Group Limited 2021. No commercial re-use. See rights and permissions. Published by BMJ. This article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.https://bmj.com/coronavirus/usage
spellingShingle Case Report
Roy, Devjit
Song, Justin
Awad, Nirvana
Zamudio, Paul
Treatment of unexplained coma and hypokinetic-rigid syndrome in a patient with COVID-19
title Treatment of unexplained coma and hypokinetic-rigid syndrome in a patient with COVID-19
title_full Treatment of unexplained coma and hypokinetic-rigid syndrome in a patient with COVID-19
title_fullStr Treatment of unexplained coma and hypokinetic-rigid syndrome in a patient with COVID-19
title_full_unstemmed Treatment of unexplained coma and hypokinetic-rigid syndrome in a patient with COVID-19
title_short Treatment of unexplained coma and hypokinetic-rigid syndrome in a patient with COVID-19
title_sort treatment of unexplained coma and hypokinetic-rigid syndrome in a patient with covid-19
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7929831/
https://www.ncbi.nlm.nih.gov/pubmed/33653852
http://dx.doi.org/10.1136/bcr-2020-239781
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