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New-Onset Movement Disorders Associated with COVID-19

INTRODUCTION: Movement disorders are increasingly described in hospitalized and milder cases of SARS-CoV-2 infection, despite a very low prevalence compared to the total patients. METHODS: We reviewed the scientific literature published in English, spanning from the initial descriptions of COVID-19...

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Autores principales: Brandão, Pedro Renato P., Grippe, Talyta C., Pereira, Danilo A., Munhoz, Renato P., Cardoso, Francisco
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Ubiquity Press 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8269765/
https://www.ncbi.nlm.nih.gov/pubmed/34277139
http://dx.doi.org/10.5334/tohm.595
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author Brandão, Pedro Renato P.
Grippe, Talyta C.
Pereira, Danilo A.
Munhoz, Renato P.
Cardoso, Francisco
author_facet Brandão, Pedro Renato P.
Grippe, Talyta C.
Pereira, Danilo A.
Munhoz, Renato P.
Cardoso, Francisco
author_sort Brandão, Pedro Renato P.
collection PubMed
description INTRODUCTION: Movement disorders are increasingly described in hospitalized and milder cases of SARS-CoV-2 infection, despite a very low prevalence compared to the total patients. METHODS: We reviewed the scientific literature published in English, spanning from the initial descriptions of COVID-19 until January 25, 2021, in the PubMed/MEDLINE database. RESULTS: We identified 93 new-onset movement disorders cases (44 articles) from 200 papers screened in the database or reference lists. Myoclonus was present in 63.4% (n = 59), ataxia in 38.7% (n = 36), action/postural tremor in 10.8% (n = 10), rigid-akinetic syndrome in 5.38% (n = 5), oculomotor abnormalities in 20.4% (n = 19), catatonia in 2.1% (n = 2), dystonia in 1.1% (n = 1), chorea in 1.1% (n = 1), functional (psychogenic) movement disorders in 3.2% (n = 3) of the reported COVID-19 cases with any movement disorder. Encephalopathy was a common association (n = 37, 39.78%). DISCUSSION: Comprehensive neurophysiological, clinical, and neuroimaging descriptions of movement disorders in the setting of SARS-CoV-2 infection are still lacking, and their pathophysiology may be related to inflammatory, postinfectious, or even indirect mechanisms not specific to SARS-CoV-2, such as ischemic-hypoxic brain insults, drug effects, sepsis, kidney failure. Cortical/subcortical myoclonus, which the cited secondary mechanisms can largely cause, seems to be the most common hyperkinetic abnormal movement, and it might occur in association with encephalopathy and ataxia. CONCLUSION: This brief review contributes to the clinical description of SARS-CoV-2 potential neurological manifestations, assisting clinical neurologists in identifying features of these uncommon syndromes as a part of COVID-19 symptomatology. HIGHLIGHTS: – Movement disorders are probably uncommon neurological manifestations in SARS-CoV-2 infection; – Myoclonus is the most reported movement disorder associated with COVID-19, its clinical complications or pharmacological management; – The pathophysiology is yet not well-understood but can include systemic inflammation, autoimmune mechanisms, or hypoxia.
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spelling pubmed-82697652021-07-16 New-Onset Movement Disorders Associated with COVID-19 Brandão, Pedro Renato P. Grippe, Talyta C. Pereira, Danilo A. Munhoz, Renato P. Cardoso, Francisco Tremor Other Hyperkinet Mov (N Y) Review INTRODUCTION: Movement disorders are increasingly described in hospitalized and milder cases of SARS-CoV-2 infection, despite a very low prevalence compared to the total patients. METHODS: We reviewed the scientific literature published in English, spanning from the initial descriptions of COVID-19 until January 25, 2021, in the PubMed/MEDLINE database. RESULTS: We identified 93 new-onset movement disorders cases (44 articles) from 200 papers screened in the database or reference lists. Myoclonus was present in 63.4% (n = 59), ataxia in 38.7% (n = 36), action/postural tremor in 10.8% (n = 10), rigid-akinetic syndrome in 5.38% (n = 5), oculomotor abnormalities in 20.4% (n = 19), catatonia in 2.1% (n = 2), dystonia in 1.1% (n = 1), chorea in 1.1% (n = 1), functional (psychogenic) movement disorders in 3.2% (n = 3) of the reported COVID-19 cases with any movement disorder. Encephalopathy was a common association (n = 37, 39.78%). DISCUSSION: Comprehensive neurophysiological, clinical, and neuroimaging descriptions of movement disorders in the setting of SARS-CoV-2 infection are still lacking, and their pathophysiology may be related to inflammatory, postinfectious, or even indirect mechanisms not specific to SARS-CoV-2, such as ischemic-hypoxic brain insults, drug effects, sepsis, kidney failure. Cortical/subcortical myoclonus, which the cited secondary mechanisms can largely cause, seems to be the most common hyperkinetic abnormal movement, and it might occur in association with encephalopathy and ataxia. CONCLUSION: This brief review contributes to the clinical description of SARS-CoV-2 potential neurological manifestations, assisting clinical neurologists in identifying features of these uncommon syndromes as a part of COVID-19 symptomatology. HIGHLIGHTS: – Movement disorders are probably uncommon neurological manifestations in SARS-CoV-2 infection; – Myoclonus is the most reported movement disorder associated with COVID-19, its clinical complications or pharmacological management; – The pathophysiology is yet not well-understood but can include systemic inflammation, autoimmune mechanisms, or hypoxia. Ubiquity Press 2021-07-08 /pmc/articles/PMC8269765/ /pubmed/34277139 http://dx.doi.org/10.5334/tohm.595 Text en Copyright: © 2021 The Author(s) https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC-BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. See http://creativecommons.org/licenses/by/4.0/.
spellingShingle Review
Brandão, Pedro Renato P.
Grippe, Talyta C.
Pereira, Danilo A.
Munhoz, Renato P.
Cardoso, Francisco
New-Onset Movement Disorders Associated with COVID-19
title New-Onset Movement Disorders Associated with COVID-19
title_full New-Onset Movement Disorders Associated with COVID-19
title_fullStr New-Onset Movement Disorders Associated with COVID-19
title_full_unstemmed New-Onset Movement Disorders Associated with COVID-19
title_short New-Onset Movement Disorders Associated with COVID-19
title_sort new-onset movement disorders associated with covid-19
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8269765/
https://www.ncbi.nlm.nih.gov/pubmed/34277139
http://dx.doi.org/10.5334/tohm.595
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