Department of Medicine, Montefiore Nyack Hospital, Nyack, NY, USA
Department of Medicine, Albert Einstein - College of Medicine, Bronx, NY, USA.
BMJ Case Rep. 2021 Mar 2;14(3):e239781. doi: 10.1136/bcr-2020-239781.
The COVID-19 pandemic has dealt a devastating blow to healthcare systems globally. Approximately 3.2% of patients infected with COVID-19 require invasive ventilation during the course of the illness. Within this population, 25% of patients are affected with neurological manifestations. Among those who are affected by severe neurological manifestations, some may have acute cerebrovascular complications (5%), impaired consciousness (15%) or exhibit skeletal muscle hypokinesis (20%). The cause of the severe cognitive impairment and hypokinesis is unknown at this time. Potential causes include COVID-19 viral encephalopathy, toxic metabolic encephalopathy, post-intensive care unit syndrome and cerebrovascular pathology. We present a case of a 60 year old patient who sustained a prolonged hospitalization with COVID-19, had a cerebrovascular event and developed a persistent unexplained encephalopathy along with a hypokinetic state. He was treated successfully with modafinil and carbidopa/levodopa showing clinical improvement within 3-7 days and ultimately was able to successfully discharge home.
新冠疫情对全球医疗体系造成了毁灭性的打击。 大约有 3.2%的 COVID-19 感染者在病程中需要接受有创通气。在这些患者中，25%会出现神经系统表现。在那些受到严重神经系统表现影响的患者中，有些人可能会出现急性脑血管并发症（5%）、意识障碍（15%）或出现骨骼肌运动减退（20%）。目前尚不清楚造成严重认知障碍和运动减退的原因。潜在原因包括 COVID-19 病毒性脑病、毒性代谢性脑病、重症监护后综合征和脑血管病理学。我们报告了一例 60 岁患者的病例，该患者因 COVID-19 而长时间住院，发生了脑血管事件，并出现持续且无法解释的脑病以及运动减退状态。他成功地接受了莫达非尼和卡比多巴/左旋多巴治疗，在 3-7 天内出现了临床改善，最终成功出院回家。
