ABSTRACT
BACKGROUND: Neurological symptoms are common manifestation in acute COVID-19. This includes hyper- and hypokinetic movement disorders. Data on their outcome, however, is limited. METHODS: Cases with new-onset COVID-19-associated movement disorders were identified by searching the literature. Authors were contacted for outcome data which were reviewed and analyzed. RESULTS: Movement disorders began 12.6 days on average after the initial onset of COVID-19. 92% of patients required hospital admission (mean duration 23 days). In a fraction of patients (6 of 27; 22%; 4 males/2 females, mean age 66.8 years) the movement disorder (ataxia, myoclonus, tremor, parkinsonism) was still present after a follow-up period of 7.5 ± 3 weeks. Severe COVID-19 in general and development of encephalopathy were risk factors, albeit not strong predictors, for the persistence. CONCLUSIONS: The prognosis of new-onset COVID-19-associated movement disorder appears to be generally good. The majority recovered without residual symptoms within several weeks or months. Permanent cases may be due to unmasking of a previous subclinical movement disorder or due to vascular/demyelinating damage. Given the relatively low response rate of one third only and the heterogeneity of mechanisms firm conclusions on the (long-term) outome cannot, however, be drawn.
Subject(s)
COVID-19 , Movement Disorders , Male , Female , Humans , Aged , COVID-19/complications , Follow-Up Studies , Movement Disorders/etiology , Risk Factors , Tremor/complicationsSubject(s)
Apraxias , COVID-19 , Movement Disorders , Humans , Movement Disorders/therapy , Patient Care , SARS-CoV-2ABSTRACT
BACKGROUND: The COVID-19 pandemic has compelled countries to impose lockdowns to curb the spread. As a result of the lockdown and need for health care services to cater to acute diseases on priority, patients with chronic illnesses such as Parkinson's disease (PD) may be facing several difficulties. AIMS: This study aimed to explore the effects of prolongation of lockdown on patients with PD by evaluating possible problems faced during a lockdown and worsening of symptoms if any. MATERIALS AND METHODS: One hundred patients with PD and their caregivers were contacted. RESULTS: We observed a significant increase in problems faced due to this pandemic, specifically, the inability to access health care, and difficulty procuring medication. Patients also reported worsening of motor symptoms. CONCLUSIONS: The present findings highlight the need for health care systems to consider a plan of action for chronic neurological diseases like PD, which are worsening in the absence of regular hospital visits.
Subject(s)
Betacoronavirus/pathogenicity , Caregivers , Coronavirus Infections/epidemiology , Parkinson Disease/virology , Pneumonia, Viral/epidemiology , Adult , COVID-19 , Coronavirus Infections/complications , Delivery of Health Care/statistics & numerical data , Female , Hospitals/statistics & numerical data , Humans , Male , Middle Aged , Pandemics , Parkinson Disease/complications , Pneumonia, Viral/complications , SARS-CoV-2ABSTRACT
OBJECTIVE: The novel coronavirus disease (COVID-19) pandemic and public health measures to control it have resulted in unique challenges in the management of patients with deep brain stimulation (DBS). We report our experience with the management of acute worsening of symptoms due to battery exhaustion in 3 patients with DBS. METHODS: Patients with DBS for movement disorders who visited the emergency room due to battery exhaustion during the nationwide lockdown from April to May 2020 were included. RESULTS: Two patients with subthalamic nucleus-DBS for Parkinson's disease (PD) and one with globus pallidus interna-DBS for generalized dystonia presented with acute worsening of symptoms due to battery exhaustion. Urgent battery replacement was performed in both patients with PD. The patient with generalized dystonia was managed with medication adjustment as he chose to defer battery replacement. CONCLUSION: DBS battery replacement can be an emergency. Decisions regarding DBS battery replacement should be individualized during this COVID-19 pandemic.