Parkinsonism as a Third Wave of the COVID-19 Pandemic?

Since the initial reports of COVID-19 in December 2019, the world has been gripped by the disastrous acute respiratory disease caused by the SARS-CoV-2 virus. There are an ever-increasing number of reports of neurological symptoms in patients, from severe (encephalitis), to mild (hyposmia), suggesting the potential for neurotropism of SARS-CoV-2. This Perspective investigates the hypothesis that the reliance on self-reporting of hyposmia has resulted in an underestimation of neurological symptoms in COVID-19 patients. While the acute effect of the virus on the nervous system function is vastly overshadowed by the respiratory effects, we propose that it will be important to monitor convalescent individuals for potential long-term implications that may include neurodegenerative sequelae such as viral-associated parkinsonism. As it is possible to identify premorbid harbingers of Parkinson's disease, we propose long-term screening of SARS-CoV-2 cases post-recovery for these expressions of neurodegenerative disease. An accurate understanding of the incidence of neurological complications in COVID-19 requires long-term monitoring for sequelae after remission and a strategized health policy to ensure healthcare systems all over the world are prepared for a third wave of the virus in the form of parkinsonism.

Topographic amnesia: spatial memory disorder, perceptual dysfunction, or category specific semantic memory impairment?

A 60 year old patient, SE, who presented with a severe difficulty in finding his way around previously familiar environments and a mild prosopagnosia is described. SE had herpes simplex encephalitis resulting in selective right temporal lobe damage. He showed normal spatial learning, but was severely imparied in his ability to recognise pictures of buildings and landmarks. The disorder was not confined to the visual modality, but rather involved a loss of knowledge about famous buildings and landmarks when tested from their spoken name. SE was contrasted with a more severely prosopagnosic patient, PHD, who showed normal ability to recognise buildings and landmarks, indicating that recognition of people dissociates from recognition of buildings/landmarks. It is concluded that SE's failure of place knowledge represents a category specific supramodal semantic memory impairment.