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Acute hypokinetic-rigid syndrome following SARS-CoV-2 infection.
Méndez-Guerrero, Antonio; Laespada-García, María Isabel; Gómez-Grande, Adolfo; Ruiz-Ortiz, Mariano; Blanco-Palmero, Víctor Antonio; Azcarate-Diaz, Francisco Javier; Rábano-Suárez, Pablo; Álvarez-Torres, Eva; de Fuenmayor-Fernández de la Hoz, Carlos Pablo; Vega Pérez, Diana; Rodríguez-Montalbán, Raquel; Pérez-Rivilla, Alfredo; Sayas Catalán, Javier; Ramos-González, Ana; González de la Aleja, Jesús.
  • Méndez-Guerrero A; From the Departments of Neurology (A.M.-G., M.I.L.-G., M.R.-O., V.A.B.-P., F.J.Z.-D., P.R.-S, C.P.d.F.-F.d.l.H., J.G.d.l.A.), Nuclear Medicine (A.G.-G., D.V.P.), Anesthesiology (E.A.-T., R.R.-M.), Microbiology (A.P.-Z.), Pneumology (J.S.C.), and Neuroradiology (A.R.-G.), Hospital Universitario 12 de
  • Laespada-García MI; From the Departments of Neurology (A.M.-G., M.I.L.-G., M.R.-O., V.A.B.-P., F.J.Z.-D., P.R.-S, C.P.d.F.-F.d.l.H., J.G.d.l.A.), Nuclear Medicine (A.G.-G., D.V.P.), Anesthesiology (E.A.-T., R.R.-M.), Microbiology (A.P.-Z.), Pneumology (J.S.C.), and Neuroradiology (A.R.-G.), Hospital Universitario 12 de
  • Gómez-Grande A; From the Departments of Neurology (A.M.-G., M.I.L.-G., M.R.-O., V.A.B.-P., F.J.Z.-D., P.R.-S, C.P.d.F.-F.d.l.H., J.G.d.l.A.), Nuclear Medicine (A.G.-G., D.V.P.), Anesthesiology (E.A.-T., R.R.-M.), Microbiology (A.P.-Z.), Pneumology (J.S.C.), and Neuroradiology (A.R.-G.), Hospital Universitario 12 de
  • Ruiz-Ortiz M; From the Departments of Neurology (A.M.-G., M.I.L.-G., M.R.-O., V.A.B.-P., F.J.Z.-D., P.R.-S, C.P.d.F.-F.d.l.H., J.G.d.l.A.), Nuclear Medicine (A.G.-G., D.V.P.), Anesthesiology (E.A.-T., R.R.-M.), Microbiology (A.P.-Z.), Pneumology (J.S.C.), and Neuroradiology (A.R.-G.), Hospital Universitario 12 de
  • Blanco-Palmero VA; From the Departments of Neurology (A.M.-G., M.I.L.-G., M.R.-O., V.A.B.-P., F.J.Z.-D., P.R.-S, C.P.d.F.-F.d.l.H., J.G.d.l.A.), Nuclear Medicine (A.G.-G., D.V.P.), Anesthesiology (E.A.-T., R.R.-M.), Microbiology (A.P.-Z.), Pneumology (J.S.C.), and Neuroradiology (A.R.-G.), Hospital Universitario 12 de
  • Azcarate-Diaz FJ; From the Departments of Neurology (A.M.-G., M.I.L.-G., M.R.-O., V.A.B.-P., F.J.Z.-D., P.R.-S, C.P.d.F.-F.d.l.H., J.G.d.l.A.), Nuclear Medicine (A.G.-G., D.V.P.), Anesthesiology (E.A.-T., R.R.-M.), Microbiology (A.P.-Z.), Pneumology (J.S.C.), and Neuroradiology (A.R.-G.), Hospital Universitario 12 de
  • Rábano-Suárez P; From the Departments of Neurology (A.M.-G., M.I.L.-G., M.R.-O., V.A.B.-P., F.J.Z.-D., P.R.-S, C.P.d.F.-F.d.l.H., J.G.d.l.A.), Nuclear Medicine (A.G.-G., D.V.P.), Anesthesiology (E.A.-T., R.R.-M.), Microbiology (A.P.-Z.), Pneumology (J.S.C.), and Neuroradiology (A.R.-G.), Hospital Universitario 12 de
  • Álvarez-Torres E; From the Departments of Neurology (A.M.-G., M.I.L.-G., M.R.-O., V.A.B.-P., F.J.Z.-D., P.R.-S, C.P.d.F.-F.d.l.H., J.G.d.l.A.), Nuclear Medicine (A.G.-G., D.V.P.), Anesthesiology (E.A.-T., R.R.-M.), Microbiology (A.P.-Z.), Pneumology (J.S.C.), and Neuroradiology (A.R.-G.), Hospital Universitario 12 de
  • de Fuenmayor-Fernández de la Hoz CP; From the Departments of Neurology (A.M.-G., M.I.L.-G., M.R.-O., V.A.B.-P., F.J.Z.-D., P.R.-S, C.P.d.F.-F.d.l.H., J.G.d.l.A.), Nuclear Medicine (A.G.-G., D.V.P.), Anesthesiology (E.A.-T., R.R.-M.), Microbiology (A.P.-Z.), Pneumology (J.S.C.), and Neuroradiology (A.R.-G.), Hospital Universitario 12 de
  • Vega Pérez D; From the Departments of Neurology (A.M.-G., M.I.L.-G., M.R.-O., V.A.B.-P., F.J.Z.-D., P.R.-S, C.P.d.F.-F.d.l.H., J.G.d.l.A.), Nuclear Medicine (A.G.-G., D.V.P.), Anesthesiology (E.A.-T., R.R.-M.), Microbiology (A.P.-Z.), Pneumology (J.S.C.), and Neuroradiology (A.R.-G.), Hospital Universitario 12 de
  • Rodríguez-Montalbán R; From the Departments of Neurology (A.M.-G., M.I.L.-G., M.R.-O., V.A.B.-P., F.J.Z.-D., P.R.-S, C.P.d.F.-F.d.l.H., J.G.d.l.A.), Nuclear Medicine (A.G.-G., D.V.P.), Anesthesiology (E.A.-T., R.R.-M.), Microbiology (A.P.-Z.), Pneumology (J.S.C.), and Neuroradiology (A.R.-G.), Hospital Universitario 12 de
  • Pérez-Rivilla A; From the Departments of Neurology (A.M.-G., M.I.L.-G., M.R.-O., V.A.B.-P., F.J.Z.-D., P.R.-S, C.P.d.F.-F.d.l.H., J.G.d.l.A.), Nuclear Medicine (A.G.-G., D.V.P.), Anesthesiology (E.A.-T., R.R.-M.), Microbiology (A.P.-Z.), Pneumology (J.S.C.), and Neuroradiology (A.R.-G.), Hospital Universitario 12 de
  • Sayas Catalán J; From the Departments of Neurology (A.M.-G., M.I.L.-G., M.R.-O., V.A.B.-P., F.J.Z.-D., P.R.-S, C.P.d.F.-F.d.l.H., J.G.d.l.A.), Nuclear Medicine (A.G.-G., D.V.P.), Anesthesiology (E.A.-T., R.R.-M.), Microbiology (A.P.-Z.), Pneumology (J.S.C.), and Neuroradiology (A.R.-G.), Hospital Universitario 12 de
  • Ramos-González A; From the Departments of Neurology (A.M.-G., M.I.L.-G., M.R.-O., V.A.B.-P., F.J.Z.-D., P.R.-S, C.P.d.F.-F.d.l.H., J.G.d.l.A.), Nuclear Medicine (A.G.-G., D.V.P.), Anesthesiology (E.A.-T., R.R.-M.), Microbiology (A.P.-Z.), Pneumology (J.S.C.), and Neuroradiology (A.R.-G.), Hospital Universitario 12 de
  • González de la Aleja J; From the Departments of Neurology (A.M.-G., M.I.L.-G., M.R.-O., V.A.B.-P., F.J.Z.-D., P.R.-S, C.P.d.F.-F.d.l.H., J.G.d.l.A.), Nuclear Medicine (A.G.-G., D.V.P.), Anesthesiology (E.A.-T., R.R.-M.), Microbiology (A.P.-Z.), Pneumology (J.S.C.), and Neuroradiology (A.R.-G.), Hospital Universitario 12 de
Neurology ; 95(15): e2109-e2118, 2020 10 13.
Article in English | MEDLINE | ID: covidwho-638341
ABSTRACT

OBJECTIVE:

To report a case of a patient infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) who acutely developed a hypokinetic-rigid syndrome.

METHODS:

Patient data were obtained from medical records from the Hospital Universitario 12 de Octubre in Madrid, Spain. [123I]-ioflupane dopamine transporter (DaT) SPECT images were acquired 4 hours after a single dose of 185 MBq of 123I-FP-CIT. Quantitative analysis was performed with DaTQUANT software providing the specific binding ratio and z score values of the striatum.

RESULTS:

We report a previously healthy 58-year-old man who developed hyposmia, generalized myoclonus, fluctuating and transient changes in level of consciousness, opsoclonus, and an asymmetric hypokinetic-rigid syndrome with ocular abnormalities after a severe SARS-CoV-2 infection. DaT-SPECT confirmed a bilateral decrease in presynaptic dopamine uptake asymmetrically involving both putamina. Significant improvement in the parkinsonian symptoms was observed without any specific treatment.

CONCLUSION:

This case study provides clinical and functional neuroimaging evidence to support that SARS-CoV-2 can gain access to the CNS, affecting midbrain structures and leading to neurologic signs and symptoms.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Parkinson Disease, Postencephalitic / Pneumonia, Viral / Putamen / Coronavirus Infections Type of study: Case report / Prognostic study Topics: Long Covid / Vaccines Limits: Humans / Male / Middle aged Language: English Journal: Neurology Year: 2020 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Parkinson Disease, Postencephalitic / Pneumonia, Viral / Putamen / Coronavirus Infections Type of study: Case report / Prognostic study Topics: Long Covid / Vaccines Limits: Humans / Male / Middle aged Language: English Journal: Neurology Year: 2020 Document Type: Article