Unité des Ataxies Cérébelleuses, Service de Neurologie, CHU-Charleroi, 6000, Charleroi, Belgium.
CHU-Charleroi and Service des Neurosciences, University of Mons, 7000, Mons, Belgium.
Cerebellum. 2020 Aug;19(4):562-568. doi: 10.1007/s12311-020-01139-1.
The current worldwide severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic that causes coronavirus disease 2019 (COVID-19) has brought some medical systems to the brink of collapse. This crisis is also negatively impacting the care of patients with non-COVID-19 conditions, including those with cerebellar ataxia (CA). Older patients with CA and those with immune-mediated ataxias on immunosuppressive medication are potentially at high risk of developing serious complications of the infection, although it is also possible that immunosuppressive agents may provide a defense against cytokine storm. This has implications for even greater attention to preventing contracting the disease through physical distancing and/or isolation. The CA patient population is also at higher risk because of the neurological complexities of their underlying disorder and the comorbid medical illnesses that often accompany the genetic ataxias. As the disruption of social patterns and healthcare delivery in response to the crisis continues, interruption of rehabilitation, speech and language therapy, and face-to-face consultations threatens to have a negative impact on the course and well-being of CA patients. Mental and physical health is also potentially at greater risk because the prevailing uncertainty and anxiety may be superimposed upon cerebellum-specific neuropsychological challenges. We identify and review some of the short- and long-term consequences of this global pandemic for the community of ataxia patients and their families and for the clinical and academic neurologists/ataxiologists caring for these patients. This includes the recognition that telemedicine has emerged as a principle means of caregiver-patient contact and that neurological manifestations of COVID-19 including those specific to cerebellar neurobiology are increasingly recognized and will require close surveillance and monitoring. This COVID-19 Cerebellum Task Force consensus provides some guidance on how we may approach this uncertain time and consider preparing for the new realities we face in CA patient care once this acute crisis has passed.
当前全球严重急性呼吸系统综合征冠状病毒 2（SARS-CoV-2）大流行导致 2019 年冠状病毒病（COVID-19），使一些医疗系统濒临崩溃。这场危机也对非 COVID-19 患者的护理产生了负面影响，包括小脑共济失调（CA）患者。患有 CA 的老年患者和接受免疫抑制药物治疗的免疫介导性共济失调患者，感染后发生严重并发症的风险较高，尽管免疫抑制剂也可能为对抗细胞因子风暴提供防御。这意味着需要更加重视通过保持身体距离和/或隔离来预防感染。CA 患者人群由于其潜在疾病的神经学复杂性以及常伴随遗传性共济失调的合并医疗疾病，因此面临更高的风险。随着应对危机的社会模式和医疗保健的中断继续，康复、言语和语言治疗以及面对面咨询的中断有可能对 CA 患者的病程和健康状况产生负面影响。精神和身体健康也可能面临更大的风险，因为普遍的不确定性和焦虑可能会叠加在小脑特定的神经心理学挑战之上。我们确定并审查了这场全球大流行对共济失调患者及其家属社区以及为这些患者提供治疗的临床和学术神经病学家/共济失调学家的一些短期和长期后果。这包括认识到远程医疗已成为照顾者与患者联系的主要手段，以及 COVID-19 的神经系统表现，包括与小脑神经生物学相关的表现，越来越受到认识，并将需要密切监测和监控。这个 COVID-19 小脑工作组共识提供了一些指导，说明我们如何应对这个不确定的时期，并考虑在这场急性危机过去后，为我们在 CA 患者护理中面临的新现实做好准备。
