Cerebellar ataxia, an unusual symptom of CoViD pneumonia in an elderly patient

ABSTRACT

Background: Neurological manifestations in SARS-CoV-2 are heterogeneous, ranging from mild symptoms such as anosmia and hypogeusia/ ageusia to more severe pictures such as stroke, seizures, ataxia, polyradiculoneuropathy, encephalopathy and movement disorders. Between the neurologic disorders, ataxia is a relatively uncommon manifestation of CNS involvement by SARS-CoV-2. Description of the case A patient with 78 years of age and other very good general conditions, was admitted to the emergency room after the onset of ataxia associated with the ideomotor slowdown. He had no active disease until the beginning of ataxia, and occasionally he exercises very actively. He had as a single episode of fever (39 C). He performed nose pharyngeal swab, resulted positive. The value of his blood gas analysis was always acceptable, but he had a mild reduction of SpO2 during the walking test. During the hospitalisation, imaging included a chest computed tomography (CT) that showed pneumonia. A brain CT showed a mild hypodensity of the cerebral white matter as chronic cerebrovascular disease. He also performed a neurological consultation. Physicians chose to administer dexamethasone 6 mg iv and enoxaparin sodium 60 mg per Kg of weight subcutaneously, antibiotic therapy and a low flow of oxygen therapy. Conclusions: The particularity of this case is the presence of ataxia as a single symptom of CoViD disease in an elderly patient with SARS-CoV-2 pneumonia. Typical presentations of CoViD-19 generally included symptoms such as fever, dry cough and dyspnoea;in elderly has been often reported the absence of these symptoms.