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Electrophysiological features of acute inflammatory demyelinating polyneuropathy associated with SARS-CoV-2 infection.
Uncini, Antonino; Foresti, Camillo; Frigeni, Barbara; Storti, Benedetta; Servalli, Maria Cristina; Gazzina, Stefano; Cosentino, Giuseppe; Bianchi, Francesca; Del Carro, Ubaldo; Alfonsi, Enrico; Piccinelli, Stefano Cotti; De Maria, Giovanni; Padovani, Alessandro; Filosto, Massimiliano; Ippoliti, Luigi.
  • Uncini A; Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio", Chieti, Italy. Electronic address: uncini@unich.it.
  • Foresti C; Neuropathophysiology, "Papa Giovanni XXIII" Hospital, Bergamo, Italy.
  • Frigeni B; Neuropathophysiology, "Papa Giovanni XXIII" Hospital, Bergamo, Italy.
  • Storti B; Neuropathophysiology, "Papa Giovanni XXIII" Hospital, Bergamo, Italy.
  • Servalli MC; Neuropathophysiology, "Papa Giovanni XXIII" Hospital, Bergamo, Italy.
  • Gazzina S; Neuropathophysiology, ASST Spedali Civili, Brescia, Italy.
  • Cosentino G; Department of Brain and Behavioral Sciences, University of Pavia and IRCCS Mondino Foundation, Pavia, Italy.
  • Bianchi F; Neurology and Neurophysiology Unit, IRCCS San Raffaele Scientific Institute, Vita Salute San Raffaele University, Milano, Italy.
  • Del Carro U; Neurology and Neurophysiology Unit, IRCCS San Raffaele Scientific Institute, Vita Salute San Raffaele University, Milano, Italy.
  • Alfonsi E; IRCCS Mondino Foundation, Pavia, Italy.
  • Piccinelli SC; Center for Neuromuscular Diseases, Unit of Neurology, ASST Spedali Civili and University of Brescia, Brescia, Italy.
  • De Maria G; Neuropathophysiology, ASST Spedali Civili, Brescia, Italy.
  • Padovani A; Center for Neuromuscular Diseases, Unit of Neurology, ASST Spedali Civili and University of Brescia, Brescia, Italy.
  • Filosto M; Center for Neuromuscular Diseases, Unit of Neurology, ASST Spedali Civili and University of Brescia, Brescia, Italy.
  • Ippoliti L; Statistics Unit, Department of Economics, University "G. d'Annunzio", Pescara, Italy.
Neurophysiol Clin ; 51(2): 183-191, 2021 Mar.
Article in English | MEDLINE | ID: covidwho-1087170
ABSTRACT

OBJECTIVE:

To assess whether patients with acute inflammatory demyelinating polyneuropathy (AIDP) associated with SARS-CoV-2 show characteristic electrophysiological features.

METHODS:

Clinical and electrophysiological findings of 24 patients with SARS-CoV-2 infection and AIDP (S-AIDP) and of 48 control AIDP (C-AIDP) without SARS-CoV-2 infection were compared.

RESULTS:

S-AIDP patients more frequently developed respiratory failure (83.3% vs. 25%, P=0.000) and required intensive care unit (ICU) hospitalization (58.3% vs. 31.3%, P=0.000). In C-AIDP, distal motor latencies (DMLs) were more frequently prolonged (70.9% vs. 26.2%, P=0.000) whereas in S-AIDP distal compound muscle action potential (dCMAP) durations were more frequently increased (49.5% vs. 32.4%, P=0.002) and F waves were more often absent (45.6% vs. 31.8%, P=0.011). Presence of nerves with increased dCMAP duration and normal or slightly prolonged DML was elevenfold higher in S-AIDP (31.1% vs. 2.8%, P=0.000);11 S-AIDP patients showed this pattern in 2 nerves.

CONCLUSION:

Increased dCMAP duration, thought to be a marker of acquired demyelination, can also be oserved in critical illness myopathy. In S-AIDP patients, an increased dCMAP duration dissociated from prolonged DML, suggests additional muscle fiber conduction slowing, possibly due to a COVID-19-related hyperinflammatory state. Absent F waves, at least in some S-AIDP patients, may reflect α-motor neuron hypoexcitability because of immobilization during the ICU stay. These features should be considered in the electrodiagnosis of SARS-CoV-2 patients with weakness, to avoid misdiagnosis.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Guillain-Barre Syndrome / COVID-19 Type of study: Prognostic study Topics: Long Covid Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: English Journal: Neurophysiol Clin Journal subject: Physiology / Neurology Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Guillain-Barre Syndrome / COVID-19 Type of study: Prognostic study Topics: Long Covid Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: English Journal: Neurophysiol Clin Journal subject: Physiology / Neurology Year: 2021 Document Type: Article