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COVID-19 后急性或亚急性口咽期吞咽障碍患者的颅神经损伤。

Cranial nerves impairment in post-acute oropharyngeal dysphagia after COVID-19.

机构信息

Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy -

Department of Rehabilitation, Habilita Care and Research Hospitals, Clinical Institute of Sarnico, Sarnico, Bergamo, Italy.

出版信息

Eur J Phys Rehabil Med. 2020 Dec;56(6):853-857. doi: 10.23736/S1973-9087.20.06452-7. Epub 2020 Sep 17.

Abstract

BACKGROUND

According to literature, after COVID-19, patients may require rehabilitation care because of different degrees of physical impairments. Neurologic disorders are often described but no specific data about postacute cranial nerves involvement and possible correlation with dysphagia development are yet available.

CASE REPORT

The patient is a 69-year-old man who presented acquired weakness and dysphagia with clinical cranial nerves impairment of lingual, IX, X and XII after SARS-CoV-2 infection, without electrophysiological alterations. He underwent rehabilitation program for two months, with slow recovery. However, at discharge residual hypoglossal nerve deficit sign was present.

CLINICAL REHABILITATION IMPACT

This single case expands knowledge about clinical picture after SARS-CoV-2 disease. Is important to notice that cranial, particularly bulbar nerves could be involved as late complications. Thus, we discuss about risk factors, the nature of the damage and the impact in dysphagia pathophysiology and recovery. If supported by further studies, this case may help to understand dysphagia features in these patients.

摘要

背景

根据文献,COVID-19 后,患者可能因不同程度的身体损伤而需要康复护理。神经系统疾病常被描述,但尚无关于急性后期颅神经受累及其与吞咽困难发展之间可能存在的相关性的具体数据。

病例报告

患者为 69 岁男性,在 SARS-CoV-2 感染后出现获得性无力和吞咽困难,伴有舌、IX、X 和 XII 临床颅神经损伤,无电生理改变。他接受了两个月的康复治疗,恢复缓慢。然而,出院时仍存在舌下神经缺陷的迹象。

临床康复影响

这个单一病例扩展了对 SARS-CoV-2 疾病后临床表现的认识。需要注意的是,颅神经,特别是延髓神经可能作为迟发性并发症而受累。因此,我们讨论了发病机制、损伤性质以及对吞咽困难病理生理学和恢复的影响。如果得到进一步研究的支持,该病例可能有助于理解这些患者的吞咽困难特征。

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