ABSTRACT
Functional movement disorders (FMDs) are a heterogenous group of movement abnormalities that greatly affect the quality of life of patients. They usually manifest as a result of underlying psychological or psychiatric illnesses without any known structural or neurochemical diseases. Various neurological disorders such as encephalitis, stroke, demyelination, seizures, and neuropathy have been reported by otherwise healthy individuals during the ongoing coronavirus disease 2019 (COVID-19) pandemic. Here, we describe the case of a 27-year-old woman who presented to our outpatient department with episodes of deviation of angle of mouth with variability and distractibility. Following thorough clinical evaluation and appropriate investigation, the underlying etiology was identified as FMD secondary to the restrictions imposed during the COVID-19 pandemic to contain the transmission of the virus. The lockdown, isolation, financial strain, and other pandemic-related issues are stressors that may contribute to psychogenic disorders in people.Copyright © 2021 Annals of Movement Disorders Published by Wolters Kluwer - Medknow.
ABSTRACT
Background: The protective role of CD4+ and CD8+ T cells was hypothesized based on research on SARS and MERS patients, and recent data confirms their participation in SARS-CoV-2 infection. Lymphopenia, like other coronaviruses and viral infections, is a characteristic indication in people with advanced COVID-19 disease. The study was performed on hospitalized COVID-19 patients a tertiary care center Pune, (India), to analyze peripheral white blood cell changes in lymphocytes. Methodology: The PBMCs were isolated from enrolled study participants and flow cytometry analysis was done to assess changes in peripheral white blood cells. The lymphocyte subsets including CD4+T cells, CD8+T cells, B cells, NK cytotoxic cells and NK regulatory cells were evaluated in COVID-19 patients with different disease category and compared to healthy controls. Result(s): The immunophenotypic characterization of peripheral blood cell subset was done for 50 COVID-19 patients and 14 healthy controls. These data were evaluated based on the disease severity. A total of 50 COVID-19 patients were classified as mild (n = 18), moderate (n = 17), or severe (n = 15) cases. In patients with severe SARS-Cov-2 infection, lymphocyte counts, CD8+ T cell counts were significantly reduced while an increased ratio of CD4+/CD8+ T cells, cytotoxic NK cells and B cells was observed. Conclusion(s): Our study showed that, SARS-CoV-2 infection was associated with changes in peripheral lymphocyte expression of certain subtypes. This observation can be used to predict better clinical outcomes for patients with aggressive treatment protocols for severe patients. Copyright © 2022 Authors. All rights reserved.
ABSTRACT
Introduction: The coronavirus disease-19 (COVID-19) pandemic is a global health crisis that has directly and indirectly impacted almost all populations globally. In this study, we aimed to study the impact of the COVID-19 pandemic on motor and nonmotor symptoms in patients with various movement disorders who visited our outpatient department. Materials and Methods: We conducted a prospective study using a structured questionnaire involving patients who visited our outpatient department during the COVID-19 pandemic from May 2020 to April 2021. The study was conducted at the Department of Neurology at the National Institute of Mental Health and Neuro Sciences, Bangalore. Results: A total of 208 patients with the following disorders were assessed: Parkinson's disease (n = 141), atypical parkinsonism (n = 31), dystonia (n = 15), Wilson's disease (n = 5), and other disorders (n = 16). Approximately, 3.5% of the patients had acquired the COVID-19 infection. Almost 80% of the patients had missed scheduled appointments with their physicians during this study period due to travel restrictions or the fear of traveling. Approximately, 50% of the patients experienced worsening of their motor and nonmotor symptoms. Approximately, 25% of patients availed teleconsultation facilities, and majority of them found it to be equivalent to or better than in-person consultation. Almost 80% of the patients were eager to receive the COVID-19 vaccination. Conclusion: The COVID-19 pandemic resulted in worsening of both motor and nonmotor symptoms in patients with movement disorders. Teleconsultation is a helpful option in managing the patients' symptoms during the pandemic. © 2022 Wolters Kluwer Medknow Publications. All rights reserved.